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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
76 to 100 of 184 Research Studies DisplayedYe S, Hiura G, Fleck E
Hospital readmissions after implementation of a discharge care program for patients with COVID-19 illness.
The surge of coronavirus 2019 (COVID-19) hospitalizations in New York City required rapid discharges to maintain hospital capacity. The objective of this study was to determine whether lenient provisional discharge guidelines with remote monitoring after discharge resulted in safe discharges home for patients hospitalized with COVID-19 illness. The investigators found that lenient discharge criteria in conjunction with remote monitoring after discharge were associated with a rate of early readmissions after COVID-related hospitalizations that was comparable to the rate of readmissions after other reasons for hospitalization before the COVID pandemic.
AHRQ-funded; HS024262; HS025198.
Citation: Ye S, Hiura G, Fleck E .
Hospital readmissions after implementation of a discharge care program for patients with COVID-19 illness.
J Gen Intern Med 2021 Mar;36(3):722-29. doi: 10.1007/s11606-020-06340-w..
Keywords: COVID-19, Hospital Discharge, Hospital Readmissions, Hospitals, Public Health, Hospitalization, Risk
Martin BI, Brodke DS, Wilson FA
The impact of halting elective admissions in anticipation of a demand surge due to the coronavirus pandemic (COVID-19).
This study’s objective was to estimate excess demand for hospital beds due to COVID-19 and the net financial impact of eliminating elective admissions to meet demand. An economic simulation was conducted combining epidemiological reports, the US Census, American Hospital Association Annual Survey, and the National Inpatient Sample. The base case used relied on a hospital admission rate reported by the CDC of 137.6 per 100,000, with the highest rates in people aged 65 year and older and 50-64 years. Elective admissions accounted for 20% of total hospital admissions, with an average rate of 30% unoccupied beds across hospitals. Hospitals that restricted elective care due to a COVID surge was only financial favorable if capacity was filled by a high proportion of COVID-19 cases among hospitals with low rates of elective admissions. There is a substantial financial risk to hospitals that restrict elective care.
AHRQ-funded; HS024714.
Citation: Martin BI, Brodke DS, Wilson FA .
The impact of halting elective admissions in anticipation of a demand surge due to the coronavirus pandemic (COVID-19).
Med Care 2021 Mar;59(3):213-19. doi: 10.1097/mlr.0000000000001496..
Keywords: Healthcare Cost and Utilization Project (HCUP), COVID-19, Hospitals, Healthcare Costs, Access to Care, Public Health
Malloy GSP, Puglisi L, Brandeau ML
Effectiveness of interventions to reduce COVID-19 transmission in a large urban jail: a model-based analysis.
The authors sought to estimate the impact of various mitigation strategies on COVID-19 transmission in a US jail beyond those offered in national guidelines. They found that depopulation, single celling, and asymptomatic testing within jails can be effective strategies to mitigate COVID-19 transmission in addition to standard public health measures. They recommended that decision makers prioritize reductions in the jail population, single celling, and testing asymptomatic populations as additional measures to manage COVID-19 within correctional settings.
AHRQ-funded; HS026128.
Citation: Malloy GSP, Puglisi L, Brandeau ML .
Effectiveness of interventions to reduce COVID-19 transmission in a large urban jail: a model-based analysis.
BMJ Open 2021 Feb 17;11(2):e042898. doi: 10.1136/bmjopen-2020-042898..
Keywords: COVID-19, Public Health, Vulnerable Populations, Prevention, Infectious Diseases
Anderson KE, McGinty EE, Presskreischer R
Reports of forgone medical care among US adults during the initial phase of the COVID-19 pandemic.
This survey measured the frequency of foregone medical care due to COVID-19 from March to mid-July 2020. Johns Hopkins created the COVID-19 Civic Life and Public Health Survey wave 1, with 1468 individuals completing the survey. The sample of respondents were 52% women, 63% non-Hispanic White, 12% Black, and 17% Hispanic. The mean age of respondents was 48 years. A total of 41% of respondents forwent medical care during the March to mid-July time period. Among the 1055 individuals who reported needing care, 52% reported forgoing care for any reason, 29% forwent care owing to fear of COVID-19 transmission, and 7% forwent care owing to financial concerns associated with the pandemic. Respondents lacking any health insurance were more likely to forgo care than respondents with Medicare or commercial insurance.
AHRQ-funded; HS000029.
Citation: Anderson KE, McGinty EE, Presskreischer R .
Reports of forgone medical care among US adults during the initial phase of the COVID-19 pandemic.
JAMA Netw Open 2021 Jan 4;4(1):e2034882. doi: 10.1001/jamanetworkopen.2020.34882..
Keywords: COVID-19, Access to Care, Healthcare Utilization, Public Health, Infectious Diseases
Puglisi LB, Malloy GSP, Harvey TD
Estimation of COVID-19 basic reproduction ratio in a large urban jail in the United States.
The purpose of this study was to estimate the basic reproduction ratio () of SARS-CoV-2 inside a correctional facility early in the COVID-19 pandemic. The investigators concluded that the high of SARS-CoV-2 in a large urban jail highlighted the importance of including correctional facilities in public health strategies for COVID-19. The investigators suggested that in the absence of more aggressive mitigation strategies, correctional facilities will continue to contribute to community infections.
AHRQ-funded; HS026128.
Citation: Puglisi LB, Malloy GSP, Harvey TD .
Estimation of COVID-19 basic reproduction ratio in a large urban jail in the United States.
Ann Epidemiol 2021 Jan;53:103-05. doi: 10.1016/j.annepidem.2020.09.002..
Keywords: COVID-19, Public Health, Vulnerable Populations, Prevention, Infectious Diseases
Bramante CT, Ingraham NE, Murray TA
Metformin and risk of mortality in patients hospitalised with COVID-19: a retrospective cohort analysis.
This study examined whether metformin use by patients with diagnosed with type 2 diabetes had reduced mortality when hospitalized for COVID-19. Pharmacy claims data from UnitedHealth Group’s Clinical Discovery Claims Database was used. Patient data were included if they were aged 18 years or older; had type 2 diabetes or obesity (defined based on claims); at least 6 months of continuous enrolment in 2019; and admission to hospital for COVID-19 confirmed by PCR; manual chart review by UHG; or reported from the hospital to UHG. Metformin was not associated with significant reduction in mortality among men, but there was an association with decreased mortality in women.
AHRQ-funded; HS026379.
Citation: Bramante CT, Ingraham NE, Murray TA .
Metformin and risk of mortality in patients hospitalised with COVID-19: a retrospective cohort analysis.
Lancet Healthy Longev 2021 Jan;2(1):e34-e41. doi: 10.1016/s2666-7568(20)30033-7..
Keywords: COVID-19, Hospitalization, Medication, Mortality, Risk, Diabetes, Chronic Conditions, Public Health, Infectious Diseases
Montoya A, Jenq G, Mills JP
Partnering with local hospitals and public health to manage COVID-19 outbreaks in nursing homes.
In this study, the authors described, among short-term and long-term residents at three nursing homes (NHs) in Michigan, the outbreak identification process, universal testing, point prevalence of COVID-19, and subsequent containment efforts, outcomes, and challenges. They found that proactive and coordinated steps between NH medical directors and administrators, referral hospitals including their laboratories, and local public health officials were necessary to respond rapidly to an outbreak and to limit the transmission of COVID-19. They suggested that this coordinated public health approach may save lives, minimize the burden to the healthcare system, and reduce healthcare costs.
AHRQ-funded; HS025451.
Citation: Montoya A, Jenq G, Mills JP .
Partnering with local hospitals and public health to manage COVID-19 outbreaks in nursing homes.
J Am Geriatr Soc 2021 Jan;69(1):30-36. doi: 10.1111/jgs.16869..
Keywords: Hospitals, Nursing Homes, Long-Term Care, Public Health, COVID-19, Elderly, Infectious Diseases
Selden TM, Berdahl TA
AHRQ Author: Selden TM, Berdahl TA
Risk of severe COVID-19 among workers and their household members.
Using prepandemic MEPS data, the investigators examined the prevalence of Centers for Disease Control and Prevention (CDC) risk factors for severe coronavirus disease 2019 (COVID-19). They then estimated how many adults at increased risk of severe COVID-19 held essential jobs and could not work at home (WAH) or who lived in households with such workers.
AHRQ-authored.
Citation: Selden TM, Berdahl TA .
Risk of severe COVID-19 among workers and their household members.
JAMA Intern Med 2021 Jan;181(1):120-22. doi: 10.1001/jamainternmed.2020.6249..
Keywords: Medical Expenditure Panel Survey (MEPS), COVID-19, Risk, Public Health, Infectious Diseases
Balikai SC, Badheka A, Casey A
Simulation to train pediatric ICU teams in endotracheal intubation of patients with COVID-19.
This paper describes the outcomes of pediatric intensive care unit (PICU) simulation training to safely perform endotracheal intubations in children with suspected or confirmed COVID-19. Confidence levels before and after training was measured using the Simulation Effectiveness Tool-Modified (SET-M, Likert scale 0-2). Fifty unique PICU staff members participated in 9 simulation sessions and mean confidences scores increased from 0.9 to 2.
AHRQ-funded; HS026965.
Citation: Balikai SC, Badheka A, Casey A .
Simulation to train pediatric ICU teams in endotracheal intubation of patients with COVID-19.
Pediatr Qual Saf 2021 Jan-Feb;6(1):e373. doi: 10.1097/pq9.0000000000000373..
Keywords: Children/Adolescents, COVID-19, Intensive Care Unit (ICU), Critical Care, Simulation, Training, Public Health, Infectious Diseases
Lee BY, Bartsch SM, Ferguson MC
The value of decreasing the duration of the infectious period of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.
Researchers developed a computational model of the U.S. simulating the spread of SARS-CoV-2 and the potential clinical and economic impact of reducing the infectious period duration. They reported that their study quantifies the potential effects of reducing the SARS-CoV-2 infectious period duration.
AHRQ-funded; HS023317.
Citation: Lee BY, Bartsch SM, Ferguson MC .
The value of decreasing the duration of the infectious period of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.
PLoS Comput Biol 2021 Jan;17(1):e1008470. doi: 10.1371/journal.pcbi.1008470..
Keywords: COVID-19, Respiratory Conditions, Public Health, Prevention, Infectious Diseases
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
Byrnes ME, Varlamos CJ, Rivard SJ
"You're used to being the one that can fix things…": a qualitative snapshot of colorectal surgeons during COVID-19.
This viewpoint article reflects the narratives of 58 colorectal surgeons who engaged in an in-depth qualitative interview during the COVID-19 shutdown of elective surgeries. The goal for reporting these findings is to offer a snapshot of surgeon perspectives on the delays of elective surgeries and to give voice to surgeons who were unable to perform most or all their duties as a surgeon.
AHRQ-funded; HS025365; HS000053.
Citation: Byrnes ME, Varlamos CJ, Rivard SJ .
"You're used to being the one that can fix things…": a qualitative snapshot of colorectal surgeons during COVID-19.
Dis Colon Rectum 2020 Dec;63(12):1575-78. doi: 10.1097/dcr.0000000000001818..
Keywords: Surgery, Provider: Physician, Provider, COVID-19, Public Health, Infectious Diseases
Temkin-Greener H, Guo W, Mao Y
COVID-19 pandemic in assisted living communities: results from seven states.
The purpose of this observational study was to describe variations in COVID-19 confirmed cases and deaths among assisted living (AL) residents and examine their associations with key AL characteristics. The investigators concluded that ALs with a higher proportion of minorities had more COVID-19 cases. Many of the previously identified individual risk factors were also present in this vulnerable population.
AHRQ-funded; HS024923; HS026893; HS026893.
Citation: Temkin-Greener H, Guo W, Mao Y .
COVID-19 pandemic in assisted living communities: results from seven states.
J Am Geriatr Soc 2020 Dec;68(12):2727-34. doi: 10.1111/jgs.16850..
Keywords: Elderly, Public Health, COVID-19, Nursing Homes, Vulnerable Populations, Risk
Sonik RA, Coleman-Jensen A, Parish SL
Household food insufficiency, health status and emergency healthcare utilisation among children with and without special healthcare needs.
The purpose of this study was to compare exposure to household food insufficiency and the relationship between household food insufficiency and both health status and emergency healthcare utilization among children with and without special healthcare needs (SHCN). The investigators concluded that compared with other children, children with SHCN have an elevated risk of exposure to household food insufficiency and experiencing greater reductions in health status when exposed.
AHRQ-funded; HS026317.
Citation: Sonik RA, Coleman-Jensen A, Parish SL .
Household food insufficiency, health status and emergency healthcare utilisation among children with and without special healthcare needs.
Public Health Nutr 2020 Dec;23(17):3204-10. doi: 10.1017/s1368980020000361..
Keywords: Children/Adolescents, Nutrition, Health Status, Emergency Department, Public Health
Barry CL, Han H, Presskreischer R
Public support for social safety-net policies for COVID-19 in the United States, April 2020.
Researchers examined public support for health insurance, income support, and unemployment policies during the initial phase of disease transmission and economic distress following the COVID-19 outbreak and assessed varying public support based on beliefs about the role of government. They fielded a nationally representative survey of US adults from April 7-13, 2020. Their results indicate that, during the initial phase of the COVID-19 pandemic in early April 2020, most US adults favored a range of safety-net policies to ameliorate its negative health and economic consequences, with public support being the highest among those favoring a stronger governmental role in society.
AHRQ-funded; HS000029.
Citation: Barry CL, Han H, Presskreischer R .
Public support for social safety-net policies for COVID-19 in the United States, April 2020.
Am J Public Health 2020 Dec;110(12):1811-13. doi: 10.2105/ajph.2020.305919..
Keywords: Public Health, Policy, COVID-19
Kang M, Gurbani SS, Kempker JA
The published scientific literature on COVID-19: an analysis of PubMed abstracts.
This article describes a PubMed search done on the published scientific literature on COVID-19 from first reporting of the virus in late December 2019 through Nov. 9, 2020. A total of 57,263 articles were included, with 34% ahead of print, 25.1% e-published, and 40.9% print published at the time of data extraction. There was a peak of 2277 articles the week of May 11. The origin countries of publication were United States (35.7%), followed by England (27%), and the Netherlands (8.7%). Most publications (98%) were in English followed by less than 1% each in Spanish, German, and French.
AHRQ-funded; HS025240.
Citation: Kang M, Gurbani SS, Kempker JA .
The published scientific literature on COVID-19: an analysis of PubMed abstracts.
J Med Syst 2020 Nov 25;45(1):3. doi: 10.1007/s10916-020-01678-4..
Keywords: COVID-19, Public Health, Research Methodologies, Health Services Research (HSR)
Selden TM, Berdahl TA, Fang Z
AHRQ Author: Selden TM, Berdahl TA, Fang Z
The risk of severe COVID-19 within households of school employees and school-age children.
Across the United States, school districts are grappling with questions of whether and how to reopen elementary and secondary schools in the 2020-21 academic year. Using pre-pandemic household data, the authors examined how often persons at risk of severe coronavirus disease 2019 (COVID-19) were connected to schools, either as employees or by living in the same households as school employees or school-age children.
AHRQ-authored.
Citation: Selden TM, Berdahl TA, Fang Z .
The risk of severe COVID-19 within households of school employees and school-age children.
Health Aff 2020 Nov;39(11):2002-09. doi: 10.1377/hlthaff.2020.01536..
Keywords: Medical Expenditure Panel Survey (MEPS), Children/Adolescents, COVID-19, Public Health, Risk, Infectious Diseases
Fan T, Palma M
AHRQ Author: Fan T
Behavioral counseling interventions to prevent sexually transmitted infections.
This case study of a 24-year-old cisgender woman presents three questions with answers concerning USPSTF recommendations about sexually transmitted infections and counseling.
AHRQ-authored.
Citation: Fan T, Palma M .
Behavioral counseling interventions to prevent sexually transmitted infections.
Am Fam Physician 2020 Nov 15;102(10):623-24..
Keywords: U.S. Preventive Services Task Force (USPSTF), Sexual Health, Infectious Diseases, Public Health, Prevention, Case Study, Guidelines
Misra-Hebert AD, Ji X, Nowacki AS
Impact of the COVID-19 pandemic on healthcare workers' risk of infection and outcomes in a large, integrated health system.
Researchers assessed healthcare workers (HCW) risk for COVID-19 infection, hospitalization, and intensive care unit (ICU) admission. Participants were individuals who had tested for SARS-CoV-2 infection in a large academic healthcare system. The study found that, in a large healthcare system, HCW had similar odds for testing positive, but lower odds of hospitalization, compared to non-HCW. Patient-facing HCW had higher odds of a positive test.
AHRQ-funded; HS024128.
Citation: Misra-Hebert AD, Ji X, Nowacki AS .
Impact of the COVID-19 pandemic on healthcare workers' risk of infection and outcomes in a large, integrated health system.
J Gen Intern Med 2020 Nov;35(11):3293-301. doi: 10.1007/s11606-020-06171-9..
Keywords: COVID-19, Risk, Provider: Health Personnel, Public Health, Healthcare Delivery, Infectious Diseases
Chou R, Dana T, Jungbauer R
Masks for prevention of respiratory virus infections, including SARS-CoV-2, in health care and community settings : a living rapid review.
This study examined the effectiveness of N95, surgical, and cloth masks in community and health care settings for preventing respiratory virus infections, including coronavirus. The effects of reuse or extended use of N95 masks was also studied. The authors used multiple electronic databases, including the World Health Organization COVID-19 database and medRxiv preprint server (2003 through 2020), and reference lists. Randomized trials of masks and risks for respiratory virus infection were included. The studies were abstracted and methodological limitations were assessed by one reviewer, with a second reviewer providing verification. Thirty-nine studies with 33,867 participants were included. No studies were found that evaluated reuse or extended use of N95 masks. The studies showed that COVID-19 and MERS probably decreased with use versus nonuse and possibly decreased with N95 versus surgical mask use. Random trials in community settings found not much difference between N95 versus surgical masks. The studies’ findings were not definitive.
AHRQ-funded; 290201500009I.
Citation: Chou R, Dana T, Jungbauer R .
Masks for prevention of respiratory virus infections, including SARS-CoV-2, in health care and community settings : a living rapid review.
Ann Intern Med 2020 Oct 6;173(7):542-55. doi: 10.7326/m20-3213..
Keywords: COVID-19, Respiratory Conditions, Infectious Diseases, Prevention, Public Health, Evidence-Based Practice
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
White EM, Kosar CM, Feifer RA
Variation in SARS-CoV-2 prevalence in U.S. skilled nursing facilities.
The objective of this study was to identify county and facility factors associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreaks in skilled nursing facilities (SNFs). The investigators concluded that larger SNFs and SNFs in areas of high SARS-CoV-2 prevalence were at high risk for outbreaks and must have access to universal testing to detect cases, implement mitigation strategies, and prevent further potentially avoidable cases and related complications.
AHRQ-funded; HS000011.
Citation: White EM, Kosar CM, Feifer RA .
Variation in SARS-CoV-2 prevalence in U.S. skilled nursing facilities.
J Am Geriatr Soc 2020 Oct;68(10):2167-73. doi: 10.1111/jgs.16752..
Keywords: COVID-19, Elderly, Nursing Homes, Long-Term Care, Public Health, Infectious Diseases
Auger KA, Shah SS, Richardson T
Association between statewide school closure and COVID-19 incidence and mortality in the US.
This study examined whether school closures between March and May due to the beginning of the COVID-19 pandemic was associated with decreased COVID-19 incidence and mortality. States were examined in quartiles using the number of cases per 100,000 population. States with the lowest cumulative incidence had the most significant decline (-72%) in cases compared to states with the highest incidence (-49%). States that closed schools earlier had the largest reduction in incidence and mortality.
AHRQ-funded; HS024735, HS026763, HS025138.
Citation: Auger KA, Shah SS, Richardson T .
Association between statewide school closure and COVID-19 incidence and mortality in the US.
JAMA 2020 Sep;324(9):859-70. doi: 10.1001/jama.2020.14348..
Keywords: COVID-19, Public Health, Children/Adolescents, Policy, Mortality
Buxbaum JD, Chernew ME, Fendrick AM
Contributions of public health, pharmaceuticals, and other medical care to US life expectancy changes, 1990-2015.
This study examined the contributions of public health, pharmaceuticals, and other medical care to increases in US life expectancy by 3.3 years from 1990 to 2015. Vital statistics data and cause-deletion analysis was used to identify the conditions most responsible. They found that 12 conditions most responsible for changing life expectance explained 2.9 years of net improvement. Ischemic heart disease prevention was the largest positive contributor to life expectancy, with accidental poisoning or drug overdose the largest negative contributor. Life expectancy improvement was attributed to public health 45%, 35% to pharmaceuticals, 13% to other medical care, and -7% was attributable to other/unknown factors.
AHRQ-funded; HS000055.
Citation: Buxbaum JD, Chernew ME, Fendrick AM .
Contributions of public health, pharmaceuticals, and other medical care to US life expectancy changes, 1990-2015.
Health Aff 2020 Sep;39(9):1546-56. doi: 10.1377/hlthaff.2020.00284..
Keywords: Public Health, Medication, Mortality
Rhee C, Baker M, Vaidya V
Incidence of nosocomial COVID-19 in patients hospitalized at a large US academic medical center.
Some patients are avoiding essential care for fear of contracting coronavirus disease 2019 (COVID-19) in hospitals. The purpose of this study was to assess the incidence of COVID-19 among patients hospitalized at a large US academic medical center in the 12 weeks after the first inpatient case was identified. The investigators concluded that in this cohort study of patients in a large academic medical center with rigorous infection control measures, nosocomial COVID-19 was rare during the height of the pandemic in the region.
AHRQ-funded; K08 HS025008.
Citation: Rhee C, Baker M, Vaidya V .
Incidence of nosocomial COVID-19 in patients hospitalized at a large US academic medical center.
JAMA Netw Open 2020 Sep;3(9):e2020498. doi: 10.1001/jamanetworkopen.2020.20498..
Keywords: COVID-19, Hospitalization, Hospitals, Public Health