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Topics
- Access to Care (2)
- Ambulatory Care and Surgery (1)
- Behavioral Health (1)
- Brain Injury (1)
- Cancer (1)
- Cardiovascular Conditions (1)
- Care Coordination (1)
- Care Management (2)
- Children/Adolescents (2)
- Chronic Conditions (1)
- Clinician-Patient Communication (1)
- Communication (1)
- Community-Based Practice (1)
- Cultural Competence (1)
- Data (1)
- Depression (2)
- Diagnostic Safety and Quality (2)
- Disparities (1)
- Education: Patient and Caregiver (1)
- Electronic Health Records (EHRs) (2)
- Emergency Department (1)
- Emergency Medical Services (EMS) (1)
- Healthcare Delivery (2)
- Healthcare Utilization (1)
- Health Insurance (1)
- Health Services Research (HSR) (1)
- Heart Disease and Health (1)
- Home Healthcare (1)
- Hospitalization (1)
- Human Immunodeficiency Virus (HIV) (6)
- Implementation (1)
- Injuries and Wounds (1)
- Labor and Delivery (1)
- Lifestyle Changes (2)
- Low-Income (4)
- Medical Devices (1)
- Medication (2)
- Nursing (1)
- Obesity (2)
- Organizational Change (1)
- Palliative Care (1)
- Patient-Centered Healthcare (1)
- Patient-Centered Outcomes Research (1)
- Patient and Family Engagement (1)
- Patient Experience (2)
- Patient Safety (3)
- Patient Self-Management (1)
- Practice Improvement (1)
- Pregnancy (2)
- Pressure Ulcers (1)
- Primary Care (1)
- Provider: Clinician (1)
- Provider: Pharmacist (1)
- Quality Improvement (2)
- Quality Indicators (QIs) (1)
- Quality Measures (1)
- Quality of Care (2)
- Racial and Ethnic Minorities (11)
- Respiratory Conditions (1)
- Risk (2)
- Rural/Inner-City Residents (1)
- Rural Health (2)
- Screening (3)
- Social Determinants of Health (4)
- Stroke (1)
- Teams (1)
- Telehealth (1)
- (-) Urban Health (28)
- Vulnerable Populations (6)
- Web-Based (1)
- Women (2)
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 25 of 28 Research Studies DisplayedBeck A, Davidson AJ, Xu S
A multilevel analysis of individual, health system, and neighborhood factors associated with depression within a large metropolitan area.
This study geocoded depression diagnosis and demographic data from electronic health records to obtain both individual and neighborhood factors related to depression. The researchers found higher depression rates associated with greater age, female gender, white race, medical comorbidities, and with lower rates of home owner occupancy, residential stability, and higher educational attainment, but not with economic disadvantage. Among the cohort, higher depression rates were associated with higher crime rates and a lower percent of foreign born residents and single mother households.
AHRQ-funded; HS022143.
Citation: Beck A, Davidson AJ, Xu S .
A multilevel analysis of individual, health system, and neighborhood factors associated with depression within a large metropolitan area.
J Urban Health 2017 Dec;94(6):780-90. doi: 10.1007/s11524-017-0190-x..
Keywords: Depression, Electronic Health Records (EHRs), Social Determinants of Health, Urban Health
Gao TY, Howe CJ, Zullo AR
Risk factors for self-report of not receiving an HIV test among adolescents in NYC with a history of sexual intercourse, 2013 YRBS.
This study estimated the prevalence of and identified risk factors for not receiving an HIV test among adolescents with a history of sexual intercourse in New York City (NYC), an urban area that has been greatly impacted by the HIV epidemic. The study’s findings suggested that among NYC adolescents with a history of sexual intercourse, the prevalence of HIV testing is low. HIV testing may have been low in part because of limited experience with current screening guidelines among clinicians.
AHRQ-funded; HS022998.
Citation: Gao TY, Howe CJ, Zullo AR .
Risk factors for self-report of not receiving an HIV test among adolescents in NYC with a history of sexual intercourse, 2013 YRBS.
Vulnerable Child Youth Stud 2017;12(4):277-91. doi: 10.1080/17450128.2016.1268741..
Keywords: Children/Adolescents, Human Immunodeficiency Virus (HIV), Lifestyle Changes, Screening, Urban Health
Tung EL, Cagney KA, Peek ME
Spatial context and health inequity: reconfiguring race, place, and poverty.
The authors build on the Chicago School of Sociology's contributions in urban research and one of its contemporary elaborations, often described as the "neighborhood effects approach," to propose a three-axis model of health inequity. This model, in alignment with Chicago School theory, postulates a dynamic and adaptive relationship between spatial context and health inequity. Compositional axes of race and poverty form the foundation of the model.
AHRQ-funded; HS023007.
Citation: Tung EL, Cagney KA, Peek ME .
Spatial context and health inequity: reconfiguring race, place, and poverty.
J Urban Health 2017 Dec;94(6):757-63. doi: 10.1007/s11524-017-0210-x.
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Keywords: Disparities, Low-Income, Racial and Ethnic Minorities, Social Determinants of Health, Urban Health
Hong S, Burnett-Zeigler I
The frequency of PTSD and subthreshold PTSD among African-American women with depressive symptoms in a disadvantaged urban neighborhood: pilot study.
This report examined the frequency of a post-traumatic stress disorder (PTSD) diagnosis and subthreshold PTSD among 72 female participants with depressive symptoms in a mindfulness-based intervention for depression at an urban federally qualified health center. The authors reported the high frequency of PTSD diagnosis and subthreshold PTSD among underserved women with depressive symptoms.
AHRQ-funded; HS023011.
Citation: Hong S, Burnett-Zeigler I .
The frequency of PTSD and subthreshold PTSD among African-American women with depressive symptoms in a disadvantaged urban neighborhood: pilot study.
J Racial Ethn Health Disparities 2017 Dec;4(6):1069-73. doi: 10.1007/s40615-016-0311-3.
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Keywords: Depression, Behavioral Health, Racial and Ethnic Minorities, Urban Health, Vulnerable Populations
Masterson Creber R, Chen T, Wei C
Brief report: patient activation among urban hospitalized patients with heart failure.
The purpose of this study was to identify whether patient activation is associated with patient-reported health outcomes in an urban and racially diverse inpatient sample of patients with heart failure. The study concluded that patient activation can be easily measured in hospitalized patients with heart failure and is associated with clinically meaningful patient-reported health outcomes.
AHRQ-funded; HS021816.
Citation: Masterson Creber R, Chen T, Wei C .
Brief report: patient activation among urban hospitalized patients with heart failure.
J Card Fail 2017 Nov;23(11):817-20. doi: 10.1016/j.cardfail.2017.08.452..
Keywords: Heart Disease and Health, Hospitalization, Patient and Family Engagement, Patient Self-Management, Urban Health
Sadasivaiah S, Smith DE, Goldman S
Improving best possible medication history with vulnerable patients at an urban safety net academic hospital using pharmacy technicians.
A multidisciplinary team designed an EHR-facilitated medication reconciliation program by which pharmacy technicians engaged newly admitted patients and their caregivers at the bedside to develop and electronically document the best possible medication history (BPMH). They found that, by optimizing not only the health information technology platform but also the operational processes, the program achieved a nearly 80 percent generation of BPMH completed by a highly trained pharmacy technician.
AHRQ-funded; HS022561; HS023558.
Citation: Sadasivaiah S, Smith DE, Goldman S .
Improving best possible medication history with vulnerable patients at an urban safety net academic hospital using pharmacy technicians.
BMJ Open Qual 2017 Oct 21;6(2):e000102. doi: 10.1136/bmjoq-2017-000102.
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Keywords: Electronic Health Records (EHRs), Medication, Patient Safety, Urban Health, Vulnerable Populations
Clarity C, Sarkar U, Lee J
Clinician perspectives on the management of abnormal subcritical tests in an urban academic safety-net health care system.
Missed or delayed follow-up of abnormal subcritical tests (tests that do not require immediate medical attention) can lead to poor patient outcomes. Safety-net health systems with limited resources and socially complex patients are vulnerable to safety gaps resulting from delayed management. In this study, clinician perspectives to identify system challenges, vulnerable situations, and potential solutions, were sought in focus groups.
AHRQ-funded; HS023558.
Citation: Clarity C, Sarkar U, Lee J .
Clinician perspectives on the management of abnormal subcritical tests in an urban academic safety-net health care system.
Jt Comm J Qual Patient Saf 2017 Oct;43(10):517-23. doi: 10.1016/j.jcjq.2017.05.007..
Keywords: Urban Health, Rural/Inner-City Residents, Diagnostic Safety and Quality, Patient Safety, Vulnerable Populations, Ambulatory Care and Surgery, Communication, Provider: Clinician
Squires A, Peng TR, Barrón-Vaya Y
An exploratory analysis of patient-provider language-concordant home health care visit patterns.
In a 2-year period, this study showed that among the 238,513 visits with 18,132 limited English proficiency patients, only 20 percent of visits were language concordant. The study suggests that home health care services may not be meeting the demand for language services, but more research is needed to determine the right “dose” of bilingual home care visits to optimize home care outcomes and establish a standard for care.
AHRQ-funded; HS023593.
Citation: Squires A, Peng TR, Barrón-Vaya Y .
An exploratory analysis of patient-provider language-concordant home health care visit patterns.
Home Health Care Management & Practice 2017 Aug 1;29(3):161-67. doi: 10.1177/1084822317696706.
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Keywords: Cultural Competence, Home Healthcare, Clinician-Patient Communication, Racial and Ethnic Minorities, Urban Health
Sangha RS, Naidech AM, Corado C
Challenges in the medical management of symptomatic intracranial stenosis in an urban setting.
The researchers hypothesized that recurrent stroke risk among patients treated with aggressive medical management (AMM) is similar to that found in the medical arm of the SAMMPRIS trial (Stenting and Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis). However, results indicated that recurrent stroke risk within 30 days in patients with symptomatic intracranial atherosclerotic disease was higher than that observed in the medical arm of SAMMPRIS even in the subgroup receiving AMM.
AHRQ-funded; HS023437.
Citation: Sangha RS, Naidech AM, Corado C .
Challenges in the medical management of symptomatic intracranial stenosis in an urban setting.
Stroke 2017 Aug;48(8):2158-63. doi: 10.1161/strokeaha.116.016254.
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Keywords: Brain Injury, Urban Health, Stroke, Patient-Centered Outcomes Research, Care Management
Baernholdt M, Hinton ID, Guofen Y
A national comparison of rural/urban pressure ulcer and fall rates.
Despite recent decline in hospital acquired conditions (HACs), rates for pressure ulcers (PURs) and falls (FRs) remain at levels that require improvement. Contextual factors and care processes may impact HACs. Using the National Database of Nursing Quality Indicators (NDNQI®) this study examined differences in care processes and community, hospital, and nursing unit characteristics that influence PURs and FRs in 4238 rural and urban nursing units.
AHRQ-funded; HS023147.
Citation: Baernholdt M, Hinton ID, Guofen Y .
A national comparison of rural/urban pressure ulcer and fall rates.
Online J Issues Nurs 2017 May;22(2):1-12. doi: 10.3912/OJIN.Vol22No02PPT60..
Keywords: Injuries and Wounds, Nursing, Patient Safety, Pressure Ulcers, Quality of Care, Quality Improvement, Quality Indicators (QIs), Quality Measures, Rural Health, Urban Health
Masterson Creber RM, Fleck E, Liu J
Identifying the complexity of multiple risk factors for obesity among urban Latinas.
The prevalence of obesity is rising rapidly among Hispanics/Latinas. Researchers evaluated the prevalence of being obese or overweight and associated risk factors among 630 low-income, Latina women. They found that being obese was strongly associated with having hypertension, pre-hypertension, diabetes and moderate/moderately severe/severe depression. Women who reported that finding time was a barrier to physical activity were also more likely to be obese.
AHRQ-funded; HS019853.
Citation: Masterson Creber RM, Fleck E, Liu J .
Identifying the complexity of multiple risk factors for obesity among urban Latinas.
J Immigr Minor Health 2017 Apr;19(2):275-84. doi: 10.1007/s10903-016-0433-z.
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Keywords: Racial and Ethnic Minorities, Obesity, Risk, Racial and Ethnic Minorities, Urban Health
Quigley DD, Predmore ZS, Chen AY
Implementation and sequencing of practice transformation in urban practices with underserved patients.
Researchers conducted interviews at 14 primary care practices undergoing patient-centered medical home (PCMH) transformation in a large urban federally qualified health center in California and used grounded theory to identify common themes and patterns. They concluded that full PCMH transformation took time and effort and relied on a sequential approach, with an early focus on foundational changes that included use of a robust quality improvement strategy.
AHRQ-funded; HS000029.
Citation: Quigley DD, Predmore ZS, Chen AY .
Implementation and sequencing of practice transformation in urban practices with underserved patients.
Qual Manag Health Care 2017 Jan/Mar;26(1):7-14. doi: 10.1097/qmh.0000000000000118.
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Keywords: Patient-Centered Healthcare, Urban Health, Vulnerable Populations, Practice Improvement, Organizational Change, Quality Improvement, Quality of Care, Primary Care, Healthcare Delivery, Implementation, Teams
Yoon S, Co MC, Jr., Suero-Tejeda N
A data mining approach for exploring correlates of self-reported comparative physical activity levels of urban Latinos.
The authors applied data mining techniques to a community-based behavioral dataset to build prediction models to gain insights about physical activity levels as the foundation for future interventions for urban Latinos. They identified environment factors and psychological factors. They concluded that the data mining methods were useful to build prediction models to gain insights about perceptions of physical activity behavior as compared to peers.
AHRQ-funded; HS019853; HS022961.
Citation: Yoon S, Co MC, Jr., Suero-Tejeda N .
A data mining approach for exploring correlates of self-reported comparative physical activity levels of urban Latinos.
Stud Health Technol Inform 2016;225:553-7.
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Keywords: Data, Lifestyle Changes, Racial and Ethnic Minorities, Racial and Ethnic Minorities, Urban Health
Chrisinger BW, Grossestreuer AV, Laguna MC
Characteristics of automated external defibrillator coverage in Philadelphia, PA, based on land use and estimated risk.
The authors investigated how well the likelihood of out-of-hospital cardiac arrest was met by the supply of automated external defibrillators (AED) in a dense urban environment. This article offers one method by which local officials can use spatial data to prioritize attention for AED placement and coverage.
AHRQ-funded; HS018362.
Citation: Chrisinger BW, Grossestreuer AV, Laguna MC .
Characteristics of automated external defibrillator coverage in Philadelphia, PA, based on land use and estimated risk.
Resuscitation 2016 Dec;109:9-15. doi: 10.1016/j.resuscitation.2016.09.021.
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Keywords: Medical Devices, Health Insurance, Urban Health, Cardiovascular Conditions
Bjarnadottir RI, Millery M, Fleck E
Correlates of online health information-seeking behaviors in a low-income Hispanic community.
The authors explored the correlates of online health information-seeking behaviors among Hispanic residents of a low-income urban neighborhood. They found that age and Spanish as preferred language were negatively associated with online health information-seeking, whereas education and health literacy were positively associated. They concluded that their findings have implications for designing online health information resources and interventions appropriate for the populations they are likely to reach.
AHRQ-funded; HS019853.
Citation: Bjarnadottir RI, Millery M, Fleck E .
Correlates of online health information-seeking behaviors in a low-income Hispanic community.
Inform Health Soc Care 2016 Dec;41(4):341-9. doi: 10.3109/17538157.2015.1064429.
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Keywords: Education: Patient and Caregiver, Low-Income, Racial and Ethnic Minorities, Urban Health, Web-Based
Tung EL, Peek ME, Makelarski JA
Adult BMI and access to built environment resources in a high-poverty, urban geography.
The purpose of this study is to examine the relationship between BMI and access to built environment resources in a high-poverty, urban geography. BMI was not associated with potential access to resources located nearest to home. Nearly all participants bypassed at least one nearby resource type; half bypassed nearby grocers (realized access >1 mile from home). Bypassing grocers was associated with a higher BMI.
AHRQ-funded; HS000078.
Citation: Tung EL, Peek ME, Makelarski JA .
Adult BMI and access to built environment resources in a high-poverty, urban geography.
Am J Prev Med 2016 Nov;51(5):e119-e27. doi: 10.1016/j.amepre.2016.04.019.
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Keywords: Low-Income, Obesity, Urban Health
Caldwell JT, Ford CL, Wallace SP
Intersection of living in a rural versus urban area and race/ethnicity in explaining access to health care in the United States.
The researchers examined whether living in a rural versus urban area differentially exposes populations to social conditions associated with disparities in access to health care. They cocluded that rural status confers additional disadvantage for most of the health care use measures, independently of poverty and health care supply.
AHRQ-funded; HS022811.
Citation: Caldwell JT, Ford CL, Wallace SP .
Intersection of living in a rural versus urban area and race/ethnicity in explaining access to health care in the United States.
Am J Public Health 2016 Aug;106(8):1463-9. doi: 10.2105/ajph.2016.303212.
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Keywords: Rural Health, Urban Health, Racial and Ethnic Minorities, Access to Care, Social Determinants of Health
Shirley DK, Kaner RJ, Glesby MJ
Screening for chronic obstructive pulmonary disease (COPD) in an urban HIV clinic: a pilot study.
This study aimed to determine the predictive value of a COPD screening strategy validated in the general population and to identify HIV-related factors associated with decreased lung function. It found that questionnaire and peak flow together had low sensitivity, but abnormal peak flow shows potential as a screening tool for COPD in HIV/AIDS. These data suggest that lung function may be influenced by HIV-related factors.
AHRQ-funded; HS000066.
Citation: Shirley DK, Kaner RJ, Glesby MJ .
Screening for chronic obstructive pulmonary disease (COPD) in an urban HIV clinic: a pilot study.
AIDS Patient Care STDS 2015 May;29(5):232-9. doi: 10.1089/apc.2014.0265..
Keywords: Human Immunodeficiency Virus (HIV), Screening, Chronic Conditions, Respiratory Conditions, Urban Health
Bares S, Eavou R, Bertozzi-Villa C
Expanded HIV testing and linkage to care: Conventional vs. Point-of-care testing and assignment of patient notification and linkage to care to an HIV care program.
This study examined the X-TLC program that used standard blood-based laboratory testing vs. point-of-care rapid testing or rapid laboratory testing with point-of-care results notification. Site coordinators and the linkage-to-care coordinator oversaw testing, test notification, and linkage to care. It concluded that HIV screening and linkage to care can be accomplished by incorporating standard testing for HIV into routine medical care.
AHRQ-funded; HS022433.
Citation: Bares S, Eavou R, Bertozzi-Villa C .
Expanded HIV testing and linkage to care: Conventional vs. Point-of-care testing and assignment of patient notification and linkage to care to an HIV care program.
Public Health Rep 2016 Jan-Feb;131 Suppl 1:107-20.
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Keywords: Healthcare Delivery, Diagnostic Safety and Quality, Human Immunodeficiency Virus (HIV), Urban Health, Vulnerable Populations
Earnshaw VA, Rosenthal L, Cunningham SD
Exploring group composition among young, urban women of color in prenatal care: implications for satisfaction, engagement, and group attendance.
The current investigation aimed to explore associations between prenatal care group composition with patient satisfaction, engagement, and group attendance among young, urban women of color. It found that women in groups with others more diverse in age reported greater patient engagement and, in turn, attended more group sessions.
AHRQ-funded; HS022986.
Citation: Earnshaw VA, Rosenthal L, Cunningham SD .
Exploring group composition among young, urban women of color in prenatal care: implications for satisfaction, engagement, and group attendance.
Womens Health Issues 2016 Jan-Feb;26(1):110-5. doi: 10.1016/j.whi.2015.09.011.
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Keywords: Racial and Ethnic Minorities, Pregnancy, Patient Experience, Women, Urban Health
Rhodes RL, Nazir F, Lopez S
Use and predictors of end-of-life care among HIV patients in a safety net health system.
The authors examined completion of advance directives, use of palliative care, and enrollment in hospice among HIV patients who receive care at an urban safety net hospital. They found that the rates of advance directive completion, palliative care use, and hospice use were low. They recommended that advances should be made in identifying those patients earlier in their disease trajectories.
AHRQ-funded; HS022418.
Citation: Rhodes RL, Nazir F, Lopez S .
Use and predictors of end-of-life care among HIV patients in a safety net health system.
J Pain Symptom Manage 2016 Jan;51(1):120-5. doi: 10.1016/j.jpainsymman.2015.08.010.
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Keywords: Human Immunodeficiency Virus (HIV), Palliative Care, Urban Health
Rokicki S, Montana L, Fink G
Impact of migration on fertility and abortion: evidence from the household and welfare study of Accra.
The researchers used detailed pregnancy and migration histories collected as part of the Household and Welfare Study of Accra (HAWS) to examine the association between migration and pregnancy outcomes among women residing in the urban slums of Accra, Ghana. They found that the completed fertility patterns of lifetime Accra residents are remarkably similar to those of residents who migrated.
AHRQ-funded; HS000055.
Citation: Rokicki S, Montana L, Fink G .
Impact of migration on fertility and abortion: evidence from the household and welfare study of Accra.
Demography 2014 Dec;51(6):2229-54. doi: 10.1007/s13524-014-0339-0..
Keywords: Pregnancy, Urban Health, Social Determinants of Health, Labor and Delivery
McIntosh S, Cirillo D, Wood N
Patient evaluation of an acute care pediatric telemedicine service in urban neighborhoods.
The authors characterized health problems prompting neighborhood telemedicine use and to assessed parent perceptions of its value. They found that family preferences and the high value placed on neighborhood telemedicine suggest such service is important, and that service provided by neighborhood telemedicine holds potential to meet a large demand for care of acute childhood illness.
AHRQ-funded; HS018912.
Citation: McIntosh S, Cirillo D, Wood N .
Patient evaluation of an acute care pediatric telemedicine service in urban neighborhoods.
Telemed J E Health 2014 Dec;20(12):1121-6. doi: 10.1089/tmj.2014.0032.
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Keywords: Children/Adolescents, Health Services Research (HSR), Patient Experience, Telehealth, Urban Health
Qato DM, Daviglus ML, Wilder J
'Pharmacy deserts' are prevalent in Chicago's predominantly minority communities, raising medication access concerns.
The authors examined whether trends in the availability of pharmacies varied across communities in Chicago with different racial or ethnic compositions and whether "pharmacy deserts," or low-access neighborhoods, were more common in segregated black and Hispanic communities than elsewhere. They found that in 2012 there were disproportionately more pharmacy deserts in segregated black communities, as well as in low-income communities and federally designated Medically Underserved Areas. These findings suggest that public policies aimed at improving access to prescription medications may need to address factors beyond insurance coverage and medication affordability.
AHRQ-funded; HS021093.
Citation: Qato DM, Daviglus ML, Wilder J .
'Pharmacy deserts' are prevalent in Chicago's predominantly minority communities, raising medication access concerns.
Health Aff 2014 Nov;33(11):1958-65. doi: 10.1377/hlthaff.2013.1397.
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Keywords: Access to Care, Medication, Provider: Pharmacist, Racial and Ethnic Minorities, Urban Health
Haukoos JS, Lyons MS, White DA
Acute HIV infection and implications of fourth-generation HIV screening in emergency departments.
This editorial discusses a study in the same journal issue that contributes substantially to the understanding of HIV screening in EDs by reporting programmatic results of nontargeted opt-out screening in a high-volume, urban ED. This study is unique in that it reports, for the first time in an ED setting, the use of fourth-generation HIV testing which improves detection of acute HIV infection.
AHRQ-funded; HS021749.
Citation: Haukoos JS, Lyons MS, White DA .
Acute HIV infection and implications of fourth-generation HIV screening in emergency departments.
Ann Emerg Med 2014 Nov;64(5):547-51. doi: 10.1016/j.annemergmed.2014.07.004..
Keywords: Human Immunodeficiency Virus (HIV), Screening, Emergency Department, Urban Health