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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 25 of 111 Research Studies DisplayedKalwani NM, Osmanlliu E, Parameswaran V
Changes in telemedicine use and ambulatory visit volumes at a multispecialty cardiovascular center during the COVID-19 pandemic.
Researchers conducted a retrospective cohort study to examine trends in telemedicine use and visit volumes across cardiology subspecialties during the early months of the COVID-19 pandemic. Data from patients with ambulatory visits at a multispecialty cardiovascular center in Northern California were analyzed. Results showed that telemedicine visits increased dramatically during the COVID period; usage was above 75% of visits in all cardiology subspecialties in April 2020, stabilizing at rates ranging from over 95% (electrophysiology) to under 25% (heart transplant and vascular medicine). Visit volumes were below pre-COVID levels from March to May 2020, but exceeded pre-COVID levels after June 2020. The researchers concluded that telemedicine can be used to deliver a significant proportion of outpatient cardiovascular care and may increase access to care in cardiology clinics.
AHRQ-funded; HS026128.
Citation: Kalwani NM, Osmanlliu E, Parameswaran V .
Changes in telemedicine use and ambulatory visit volumes at a multispecialty cardiovascular center during the COVID-19 pandemic.
J Telemed Telecare 2024 Apr; 30(3):543-48. doi: 10.1177/1357633x211073428..
Keywords: COVID-19, Telehealth, Health Information Technology (HIT), Cardiovascular Conditions, Ambulatory Care and Surgery
Aklilu AM, Kumar S, Nugent J
COVID-19-associated acute kidney injury and longitudinal kidney outcomes.
This retrospective longitudinal multicenter cohort study’s objective was to assess long-term kidney outcomes of patient who had COVID-19-associated acute kidney injury (AKI). This study was conducted in a large hospital system using electronic health records data on adult hospitalized patients with AKI and COVID-19 or other illnesses. Included patients were those 1) who were hospitalized during the COVID-19 pandemic (March 2020-June 2022), were screened for SARS-CoV-2, had AKI, and survived to discharge, or 2) had been hospitalized during the 5 years before the pandemic (October 2016-January 2020), had a positive influenza A or B test result, had AKI, and survived to discharge. The study cohort included 9624 hospitalized patients (mean age, 69.0 years; 4955 females) with AKI, including 987 patients with COVID-AKI, 276 with influenza-associated AKI, and 8361 with AKI associated with other illnesses (other-AKI). When compared with the other 2 groups, patients with COVID-19-associated AKI were slightly younger in age, had a higher baseline eGFR, worse baseline comorbidity scores, higher markers of illness severity, and longer hospital stay. Compared with the other-AKI group, the COVID-AKI group had lower major adverse kidney events (MAKE) (adjusted hazard ratio [aHR], 0.67) due to lower all-cause mortality (aHR, 0.31) and lower rates of worsened kidney function.
AHRQ-funded; HS027626.
Citation: Aklilu AM, Kumar S, Nugent J .
COVID-19-associated acute kidney injury and longitudinal kidney outcomes.
JAMA Intern Med 2024 Apr; 18(4):414-23. doi: 10.1001/jamainternmed.2023.8225..
Keywords: COVID-19, Kidney Disease and Health, Outcomes
Decker SL, Zuvekas SH
AHRQ Author: Decker SL, Zuvekas SH
A nationally representative summary of 2020 changes in the use of health care in the United States.
The authors used Medical Expenditure Panel Survey data to summarize changes in all types of health care from 2018 to 2020. The results showed that outpatient and emergency department visits, as well as inpatient admissions each fell ~35% in April 2020; dental visits fell by over 80%, and mammograms 82%. By the end of 2020, specialist physician visits recovered, though primary care and dental visits remained 12% lower than in 2019. Psychiatric visits, however, rose slightly.
AHRQ-authored.
Citation: Decker SL, Zuvekas SH .
A nationally representative summary of 2020 changes in the use of health care in the United States.
J Ambul Care Manage 2024 Apr-Jun; 47(2):64-83. doi: 10.1097/jac.0000000000000488.
Keywords: Medical Expenditure Panel Survey (MEPS), COVID-19, Healthcare Delivery, Public Health
Jiang Henke, RM RM, Fingar KR
AHRQ Author: Jiang HJ, Liang
Mortality for time-sensitive conditions at urban vs rural hospitals during the COVID-19 pandemic.
The objectives of this interrupted time-series analysis cohort study were to examine whether in-hospital mortality not related to COVID-19 changed during the pandemic for time-sensitive conditions and to assess variations by urban versus rural hospital location. Data for adult discharges from 3813 U.S. hospitals was taken from the HCUP State Inpatient Databases. The results indicated that in-hospital mortality for time-sensitive conditions increased during the COVID-19 pandemic, for sepsis, pneumonia in both rural and urban hospitals, acute myocardial infarction and gastrointestinal hemorrhage at urban hospitals, and hip fracture at rural hospitals. No significant change was found in mortality for stroke overall. The researchers concluded that strategies tailored to differing needs of urban and rural hospitals may help reduce the likelihood of excess deaths during future public health crises.
AHRQ-authored; AHRQ-funded; 290201800001C.
Citation: Jiang Henke, RM RM, Fingar KR .
Mortality for time-sensitive conditions at urban vs rural hospitals during the COVID-19 pandemic.
JAMA Netw Open 2024 Mar 4; 7(3):e241838. doi: 10.1001/jamanetworkopen.2024.1838..
Keywords: Healthcare Cost and Utilization Project (HCUP), COVID-19, Mortality, Rural Health, Urban Health, Rural/Inner-City Residents
Daw JR, MacCallum-Bridges CL, Kozhimannil KB
Continuous Medicaid eligibility during the COVID-19 pandemic and postpartum coverage, health care, and outcomes.
This study’s objective was to evaluate the association of continuous Medicaid eligibility due to the Families First Coronavirus Response Act (FFCRA) during the COVID-19 public health emergency (PHE) with postpartum health insurance, health care use, breastfeeding, and depressive symptoms. This cohort study included 47,716 respondents from the Pregnancy Risk Assessment Monitoring System (PRAMS) comparing 21 states with continuous prepolicy (2017-2019) and postpolicy (2020-2021) participation. Based on adjusted estimates, a 100% federal poverty level (FPL) increase in postpartum Medicaid eligibility was associated with a 5.1 percentage point (pp) increase in reported postpartum Medicaid enrollment, no change in commercial coverage, and a 6.6 pp decline in uninsurance, which represents a 40% reduction in postpartum uninsurance after a Medicaid-paid birth compared with the prepolicy baseline of 16.7%. Continuous Medicaid eligibility during the COVID-19 PHE was associated with significantly reduced postpartum uninsurance for people with Medicaid-paid births, but was not associated with postpartum visit attendance, contraception use, breastfeeding, or depressive symptoms at approximately 4 months postpartum. Uninsurance reductions were observed only among White and Black non-Hispanic individuals and Hispanic individuals had no change with no policy-associated changes in other outcomes.
AHRQ-funded; HS029159.
Citation: Daw JR, MacCallum-Bridges CL, Kozhimannil KB .
Continuous Medicaid eligibility during the COVID-19 pandemic and postpartum coverage, health care, and outcomes.
JAMA Health Forum 2024 Mar; 5(3):e240004. doi: 10.1001/jamahealthforum.2024.0004..
Keywords: COVID-19, Medicaid, Maternal Care, Women, Access to Care
Lang K, Atchison TJ, Singh P
Describing the monthly variability of hospital-onset Clostridioides difficile during early coronavirus disease 2019 (COVID-19) using electronic health record data.
The objectives of this retrospective cohort study were to assess the relative risk of hospital-onset Clostridioides difficile (HO-CDI) during the early months of the coronavirus 2019 (COVID-19) pandemic and to compare it with historical expectation based on patient characteristics. Secondary data was collected from the Ohio State University Wexner Medical Center electronic health records on adult patients admitted to the inpatient setting between January 2018 and May 2021. The results indicated that variations in HO-CDI incidence seemed to trend with COVID-19 incidence, but were not fully explained by the study’s case mix. The authors concluded that other factors contributing to variability in HO-CDI incidence needed to be explored.
AHRQ-funded; HS027200.
Citation: Lang K, Atchison TJ, Singh P .
Describing the monthly variability of hospital-onset Clostridioides difficile during early coronavirus disease 2019 (COVID-19) using electronic health record data.
Infect Control Hosp Epidemiol 2024 Mar; 45(3):329-34. doi: 10.1017/ice.2023.171.
Keywords: Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), COVID-19, Infectious Diseases
Hughes PM, Easterly CW, Thomas K
North Carolina Medicaid system perspectives on substance use disorder treatment policy changes during the COVID-19 pandemic.
This study’s objective was to describe perspectives from stakeholders involved in North Carolina’s Medicaid system on substance use disorder (SUD) treatment policy changes during the COVID pandemic. Researchers conducted semi-structured interviews with state agency representatives, Medicaid managed care organizations and providers, as well as three focus groups of Medicaid beneficiaries with SUD. Responses indicated that policy changes such as telehealth and take-home methadone were overall considered beneficial; staffing shortages, however, remained a substantial barrier. The researchers concluded that the policy changes should be continued, but additional steps are needed to ensure payment parity for telehealth services.
AHRQ-funded; HS000032.
Citation: Hughes PM, Easterly CW, Thomas K .
North Carolina Medicaid system perspectives on substance use disorder treatment policy changes during the COVID-19 pandemic.
J Addict Med 2024 Mar-Apr; 18(2):e1-e7. doi: 10.1097/adm.0000000000001272..
Keywords: COVID-19, Medicaid, Substance Abuse, Behavioral Health, Policy
Levander XA, VanDerSchaaf H, Barragán VG
The role of human-centered design in healthcare innovation: a digital health equity case study.
This article described a human-centered design (HCD) approach to developing solutions to health care delivery technology issues that may exacerbate existing disparities. HCD used collaborative, team-based, and empathetic approaches focused on end-user experiences. The authors shared lessons learned about implementing HCD into clinical care settings and how HCD can result in developing site-specific, patient-centered innovations to address disparities and to improve digital health equity.
AHRQ-funded; HS026370.
Citation: Levander XA, VanDerSchaaf H, Barragán VG .
The role of human-centered design in healthcare innovation: a digital health equity case study.
J Gen Intern Med 2024 Mar; 39(4):690-95. doi: 10.1007/s11606-023-08500-0..
Keywords: Telehealth, COVID-19, Health Information Technology (HIT)
Starnes LS, Starnes JR, Stopczynski T
Clinical prediction model: multisystem inflammatory syndrome in children versus Kawasaki disease.
This study aimed to develop a prediction model to differentiate between multisystem inflammatory syndrome in children (MIS-C) and Kawasaki disease (KD). Using retrospective and prospective cohort data, a logistic regression model was developed, incorporating factors such as age, laboratory values, and clinical indicators. The model showed excellent discrimination (AUC 0.96) and calibration. It offers potential usefulness in aiding the diagnosis of MIS-C but requires further validation.
AHRQ-funded; HS026122.
Citation: Starnes LS, Starnes JR, Stopczynski T .
Clinical prediction model: multisystem inflammatory syndrome in children versus Kawasaki disease.
J Hosp Med 2024 Mar; 19(3):175-84. doi: 10.1002/jhm.13290.
Keywords: Children/Adolescents, Respiratory Conditions, COVID-19, Chronic Conditions
Hernandez SE, Solomon D, Moon J
Understanding clinical implementation coordinators' experiences in deploying evidence-based interventions.
Researchers described their fluoroquinolone restriction for the prevention of Clostridioides difficile infection (FIRST) trial, a multisite clinical study which used an electronic health record-based best-practice alert to optimize the use of fluoroquinolone antibiotics in acute care settings. Their goals were to describe the roles and responsibilities of clinical implementation coordinators within antibiotic stewardship teams and to identify facilitators and barriers coordinators experienced within the implementation process. The researchers conducted directed content analysis of semistructured interviews, implementation diaries, and check-in meetings. Their results indicated that clinical implementation coordinators facilitated the implementation process via their roles and responsibilities and acted as strategic partners in the improvement of adoption and sustainability of a fluoroquinolone preauthorization protocol.
AHRQ-funded; HS026226.
Citation: Hernandez SE, Solomon D, Moon J .
Understanding clinical implementation coordinators' experiences in deploying evidence-based interventions.
Am J Health Syst Pharm 2024 Feb 8; 81(4):120-28. doi: 10.1093/ajhp/zxad272.
Keywords: Evidence-Based Practice, Implementation, COVID-19
Paglino E, Lundberg DJ, Wrigley-Field E
Excess natural-cause mortality in US counties and its association with reported COVID-19 deaths.
The authors indicate that in the United States, excess deaths reported to non-COVID-19 natural causes may represent unrecognized COVID-19 deaths, deaths caused by interruptions in health care during the pandemic, and/or deaths from the socioeconomic impacts of the pandemic. The researchers created a Bayesian hierarchical model to produce monthly estimates of excess natural-cause mortality for US counties over the first 30 months of the pandemic. The study found that from March 2020 through August 2022, 1,194,610 excess natural-cause deaths occurred nationally. A total of 162,886 of these excess natural-cause deaths were not reported to COVID-19. Overall, 15.8 excess deaths were reported to non-COVID-19 natural causes for every 100 reported COVID-19 deaths. This number was higher in nonmetropolitan counties, the West, and the South. In comparison, reported COVID-19 death counts were greater than estimates of excess natural-cause deaths in metropolitan counties in the New England and Middle Atlantic states. Increases in reported COVID-19 deaths were temporally associated with increases in excess deaths reported to non-COVID-19 natural causes in the same and/or previous month.
AHRQ-funded; HS013853.
Citation: Paglino E, Lundberg DJ, Wrigley-Field E .
Excess natural-cause mortality in US counties and its association with reported COVID-19 deaths.
Proc Natl Acad Sci U S A 2024 Feb 6; 121(6):e2313661121. doi: 10.1073/pnas.2313661121..
Keywords: COVID-19, Mortality
Bartsch SM, O'Shea KJ, John DC
The potential epidemiologic, clinical, and economic value of a universal coronavirus vaccine: a modelling study.
This paper’s objective was to develop a modelling study on the potential epidemiologic, clinical, and economic value of a universal coronavirus vaccine to be used in the U.S. The authors used a computational model representing the US population, the spread of SARS-CoV-2, and the various clinical and economic outcomes of COVID-19 such as hospitalizations, deaths, quality-adjusted life years (QALYs) lost, productivity losses, direct medical costs, and total societal costs, to explore the impact of a universal vaccine under different circumstances. They developed and populated this model using data reported by the CDC as well as observational studies conducted during the COVID-19 pandemic. The pan-coronavirus vaccine would be cost-saving as long as its vaccine efficacy is ≥10% and vaccination coverage is ≥10%. They estimated that every 1% increase in efficacy between 10% and 50% could avert an additional 395,000 infections and save $1.0 billion in total societal costs ($45.3 million in productivity losses, $1.1 billion in direct medical costs). Even when a strain-specific coronavirus virus becomes available it would remain cost-saving, as long as it takes at least 2-3 months to develop, test, and bring that more specific vaccine to the market.
AHRQ-funded; R01HS028165.
Citation: Bartsch SM, O'Shea KJ, John DC .
The potential epidemiologic, clinical, and economic value of a universal coronavirus vaccine: a modelling study.
EClinicalMedicine 2024 Feb; 68:102369. doi: 10.1016/j.eclinm.2023.102369..
Keywords: COVID-19, Vaccination, Public Health
Fleming MD, Safaeinili N, Knox M
Organizational and community resilience for COVID-19 and beyond: leveraging a system for health and social services integration.
This case study paper examined how a preexisting initiative to align health care, public health, and social services influenced COVID-19 pandemic response. In-depth interviews were conducted with administrators and frontline staff in health care, public health, and social services in Contra Costa County, California from October 2020 to May 2021. The authors interviewed 31 informants including 14 managers in public health, health care, or social services and 17 social needs case managers who coordinated services across these sectors on behalf of patients. They identified four distinct components of the county's system alignment capabilities that supported COVID-19 response, including (1) an organizational culture of adaptability fostered through earlier system alignment efforts, which included the ability and willingness to rapidly implement new organizational processes, (2) trusting relationships among organizations based on prior, positive experiences of cross-sector collaboration, (3) capacity to monitor population health of historically marginalized community members, including information infrastructures, data analytics, and population monitoring and outreach, and (4) frontline staff with flexible skills to support health and social care who had built relationships with the highest risk community members.
AHRQ-funded; HS027648.
Citation: Fleming MD, Safaeinili N, Knox M .
Organizational and community resilience for COVID-19 and beyond: leveraging a system for health and social services integration.
Health Serv Res 2024 Feb; 59(suppl 1):e14250. doi: 10.1111/1475-6773.14250..
Keywords: COVID-19, Social Determinants of Health
McAteer J, Kalluri DD, Abedon RR
Anti-spike antibody durability after SARS-CoV-2 vaccination in adolescent solid organ transplant recipients.
This study examined COVID-19 m-RNA vaccine antibody responses 6 months following the third vaccine dose (D3) of the BNT162b2 mRNA vaccination among adolescent solid organ transplant recipients (aSOTRs). The 34 participants were surveyed after they received the third dose of the vaccine and were sampled at 1-, 3-, and 6-months post-D3. All had positive anti-RBD antibody titers 6 months post-D3. Variations in titers occurred between 3 and 6 months post-D3, with 29% having decreased antibody levels at 6 months compared to 3 months and 7% reporting increased titers at 6 months. The remaining 18 had unchanged antibody titers compared to 3-month post-D3 levels. A total of 12% reported breakthrough infection within 6 months and 9% reported infection after 6-12 months following the third dose of the SARS-CoV-2 mRNA vaccine.
AHRQ-funded; HS026510.
Citation: McAteer J, Kalluri DD, Abedon RR .
Anti-spike antibody durability after SARS-CoV-2 vaccination in adolescent solid organ transplant recipients.
Pediatr Transplant 2024 Feb; 28(1):e14671. doi: 10.1111/petr.14671.
Keywords: COVID-19, Vaccination, Transplantation, Children/Adolescents
Weiss CR, Roberts M, Florell M
Best Practices for telehealth in nurse-led care settings-a qualitative study.
This study explored the implementation of telehealth in nurse-led care models during the COVID-19 pandemic in Colorado. Through interviews with 18 providers and 30 patients, best practices such as: using multiple modalities, tailored triage and scheduling, safety measures, and managing patient relationships emerged. These findings indicate that telehealth can enhance equitable care delivery, particularly in diverse communities, with nurse leaders playing a vital role in its effective utilization.
AHRQ-funded; HS028085.
Citation: Weiss CR, Roberts M, Florell M .
Best Practices for telehealth in nurse-led care settings-a qualitative study.
Policy Polit Nurs Pract 2024 Feb; 25(1):47-57. doi: 10.1177/15271544231201417.
Keywords: Telehealth, Health Information Technology (HIT), Nursing, Provider: Nurse, COVID-19
Clark SE, Bautista L, Neeb K
Post-acute sequelae of SARS-CoV-2 (PASC) in nursing home residents: a retrospective cohort study.
This retrospective cohort study was conducted at two nursing homes in Michigan to explore post-acute sequelae of SARS-CoV-2 (PASC) among residents. Minimum Data Set was used to examine trajectories of functional dependence and cognitive function. The results suggested that nursing-home residents experienced a significant functional decline persisting for nine months following acute infection. The authors concluded that further research is needed to determine whether increased rehabilitation services after COVID-19 may help mitigate this decline.
AHRQ-funded; 1HS025451.
Citation: Clark SE, Bautista L, Neeb K .
Post-acute sequelae of SARS-CoV-2 (PASC) in nursing home residents: a retrospective cohort study.
J Am Geriatr Soc 2024 Feb; 72(2):551-58. doi: 10.1111/jgs.18678.
Keywords: COVID-19, Nursing Homes
Atkinson MK, Biddinger PD, Chughtai MA
Assessing health care leadership and management for resilience and performance during crisis: the HERO-36.
The authors developed a Healthcare Emergency Response Optimization survey to examine health care organizations’ resilience and performance during crisis. The survey was administered to health care administrators and frontline staff involved in hospitals’ emergency response during the COVID-19 pandemic. Eight measures emerged to assess crisis leadership and management; informal practices mattered most for resilience, while formal practices mattered for performance. The authors identified specific practices for resilience and performance. They concluded that organizations using these measures may modify their preparedness and planning approaches to improve management in future crises.
AHRQ-funded; HS028240.
Citation: Atkinson MK, Biddinger PD, Chughtai MA .
Assessing health care leadership and management for resilience and performance during crisis: the HERO-36.
Health Care Manage Rev 2024 Jan-Mar; 49(1):14-22. doi: 10.1097/hmr.0000000000000387..
Keywords: COVID-19, Public Health
Adams DR
Availability and accessibility of mental health services for youth: a descriptive survey of safety-net health centers during the COVID-19 pandemic.
The goal of this study was to assess the availability of outpatient mental health services for children and adolescents at safety-net health centers in a large metropolitan county. A comprehensive sample of Community Mental Health Centers (CMHCs) and Federally Qualified Health Centers (FQHCs) received a 5-minute survey approximately one year after the beginning of the COVID-19 pandemic. The response indicated that 10% of health centers had closed and 20% reported that they were not offering outpatient mental health services. Reported wait times were longer at CMHCs than FQHCs. The author concluded that these findings suggested that online directories such as the SAMHSA Treatment Locator are often inaccurate or out-of-date.
AHRQ-funded; HS000084.
Citation: Adams DR .
Availability and accessibility of mental health services for youth: a descriptive survey of safety-net health centers during the COVID-19 pandemic.
Community Ment Health J 2024 Jan; 60(1):88-97. doi: 10.1007/s10597-023-01127-9..
Keywords: Children/Adolescents, Behavioral Health, Access to Care, COVID-19, Public Health
Jurlina A, Maul T, Hunsaker P
Changes in bronchiolitis characteristics during the COVID-19 pandemic: a description of pediatric emergency department visits in a community hospital, 2019-2021.
The purpose of this retrospective, cross-sectional study was to describe changes in bronchiolitis characteristics in pediatric emergency department patients in a community hospital during the COVID-19 pandemic. The researchers conducted the study with children with bronchiolitis aged 1 to 24 months during an ED visit between 2019 and 2021. The study found that bronchiolitis cases decreased by 75% from 2019 to 2020 and rose back to prepandemic levels by 2021. Radiographs, steroids, and bronchodilators decreased during the study period. Laboratory studies, viral testing, antibiotic use, and respiratory support were unchanged. The decrease in steroids and bronchodilators was related to a clinical pathway that discouraged their use. Respiratory support remained unchanged.
AHRQ-funded; HS026393.
Citation: Jurlina A, Maul T, Hunsaker P .
Changes in bronchiolitis characteristics during the COVID-19 pandemic: a description of pediatric emergency department visits in a community hospital, 2019-2021.
Clin Pediatr 2024 Jan; 63(1):73-79. doi: 10.1177/00099228231208941..
Keywords: COVID-19, Respiratory Conditions, Children/Adolescents, Emergency Department
Jardon C, Choi KR
COVID-19 experiences and mental health among graduate and undergraduate nursing students in Los Angeles.
This observational study’s purpose was to 1) describe the mental health of nursing students during the COVID-19 pandemic, (2) investigate relationships between stressful COVID-19 experiences and mental health, and (3) examine correlates of mental health service use. The authors created a web-based survey to assess COVID-19 experiences, self-reported mental health, and mental health service utilization among nursing students in Los Angeles in spring 2021 (N = 174, 30.1% response rate). The survey measured stressful COVID-19 experiences (personal COVID-19 illness, hospitalization of close friends or family, and death of close friends or family), loneliness, resilience, depression, anxiety, COVID-19-related traumatic stress, and utilization of campus and noncampus mental health services. Students were found to have high levels of depression (30%), anxiety (38%), and traumatic stress (30%). No relationship was found between stressful COVID-19 experiences and mental health, but loneliness was associated with higher odds of mental health problems and resilience with lower odds. Students with primary caregiving responsibilities (OR = 0.22) and students who identified as Asian/Pacific Islander (OR = 0.24) had lower odds of mental health service utilization.
AHRQ-funded; HS026407.
Citation: Jardon C, Choi KR .
COVID-19 experiences and mental health among graduate and undergraduate nursing students in Los Angeles.
J Am Psychiatr Nurses Assoc 2024 Jan-Feb; 30(1):86-94. doi: 10.1177/10783903211072222..
Keywords: COVID-19, Provider: Nurse, Education: Academic, Burnout
Eliason EL, Agostino J, Vivier P
Infant health care disruptions by race and ethnicity, income, and insurance during the COVID-19 pandemic.
This cross-sectional study examined the impact that the COVID-19 pandemic had on infant health care, and broke it down by race and ethnicity, income, and insurance type. This study used the Pregnancy Risk Assessment Monitoring System COVID-19 supplement with data from 29 jurisdictions to examine infant health care disruptions due to the pandemic: 1) well visits/checkups canceled or delayed, 2) well visits/checkups changed to virtual appointments, and 3) postponed immunizations. The authors found that among 12,053 parental respondents with infants born from April to December 2020, 7.25% reported cancelations or delays in infant well visits/checkups, 5.49% reported changes to virtual infant care appointments, and 5.33% reported postponing immunizations, with significant differences by race and ethnicity, income, and insurance type. They found higher odds of canceling/delaying visits and postponing immunizations among non-Hispanic Black infants and infants whose parents were uninsured or had Medicaid-paid deliveries. The odds of switching to virtual appointments was also significantly higher among Hispanic infants and infants whose parents had Medicaid-paid deliveries.
AHRQ-funded; HS000011.
Citation: Eliason EL, Agostino J, Vivier P .
Infant health care disruptions by race and ethnicity, income, and insurance during the COVID-19 pandemic.
Acad Pediatr 2024 Jan-Feb; 24(1):105-10. doi: 10.1016/j.acap.2023.07.005..
Keywords: Newborns/Infants, Racial and Ethnic Minorities, COVID-19, Access to Care, Uninsured, Health Insurance, Healthcare Delivery
Cohen TN, Berdahl CT, Coleman BL
Medication safety event reporting: Factors that contribute to safety events during times of organizational stress.
This study’s objective was to understand the insights conveyed in hospital incident reports about how work system factors affected medication safety during a coronavirus disease-2019 (COVID-19) surge. The authors randomly selected 100 medication safety incident reports from an academic medical center (December 2020 to January 2021), identified near misses and errors, and classified contributing work system factors using the Human Factors Analysis and Classification System-Healthcare. Results showed that among 35 near misses/errors, incident reports described contributing factors (mean 1.3/report) involving skill-based errors (n = 20), communication (n = 8), and tools/technology (n = 4). Seven of these events were linked to COVID-19.
AHRQ-funded; HS027455.
Citation: Cohen TN, Berdahl CT, Coleman BL .
Medication safety event reporting: Factors that contribute to safety events during times of organizational stress.
J Nurs Care Qual 2024 Jan-Mar; 39(1):51-57. doi: 10.1097/ncq.0000000000000720..
Keywords: Medication: Safety, Medication, Patient Safety, COVID-19, Adverse Drug Events (ADE), Adverse Events, Medical Errors
Cuca YP, Horvat C, Corless IB IB
The social, mental, and physical health impacts of the COVID-19 pandemic on people with HIV: protocol of an observational international multisite study.
The authors described the protocol for an international multisite observational study based on the SPIRIT guidelines to examine impact on the health and HIV outcomes for immunocompromised individuals such as people with HIV (PWH) from COVID-19 and from the strategies enacted to contain it. Investigators will recruit PWH to complete the study online or in-person. Study questions will address demographics, HIV continuum of care indicators, mental and social health, COVID-19 and vaccination knowledge, attitudes, behaviors, and fears; and overall outcomes. Results of this study can inform responses to future public health crises to minimize impacts on vulnerable populations such as PWH.
AHRQ-funded; HS028523.
Citation: Cuca YP, Horvat C, Corless IB IB .
The social, mental, and physical health impacts of the COVID-19 pandemic on people with HIV: protocol of an observational international multisite study.
J Assoc Nurses AIDS Care 2024 Jan-Feb; 35(1):60-74. doi: 10.1097/jnc.0000000000000444..
Keywords: COVID-19, Human Immunodeficiency Virus (HIV), Chronic Conditions
Mitchell JM, Kranz AM, Steiner ED
Barriers and strategies used to continue school-based health services during the COVID-19 pandemic.
This study examined perceived barriers and strategies adopted to continue the delivery of school-based health services when schools reopened in Fall of 2021 during the COVID-19 pandemic and to assess whether these barriers and strategies varied by locality. The authors developed and subsequently conducted an online survey of school nurses who worked at the 1178 public elementary schools in Virginia in May 2021 to describe the impact of the COVID-19 pandemic on the delivery of school-based health services. They compared perceived barriers, strategies adopted and the effectiveness of strategies to continue the delivery of school-based health services by geographic locality (city vs. rural; suburban vs. rural and city vs. suburban). More than half of urban schools expected nine of ten potential barriers to affect the delivery of school-based health services during Fall 2021. More than half of responding schools located in urban, suburban, and rural areas indicated that external barriers outside of their control, including insufficient funding and families not able to bring students to school, were likely to be barriers to delivering care. There was no variation in strategies identified as “very effective” by locality.
AHRQ-funded; HS025430.
Citation: Mitchell JM, Kranz AM, Steiner ED .
Barriers and strategies used to continue school-based health services during the COVID-19 pandemic.
Matern Child Health J 2024 Jan; 28(1):155-64. doi: 10.1007/s10995-023-03824-z.
Keywords: COVID-19, Children/Adolescents, Access to Care
Kravchenko OV, Boyce RD, Gomez-Lumbreras A
Drug-drug interaction between dexamethasone and direct-acting oral anticoagulants: a nested case-control study in the national COVID cohort collaborative (N3C).
This study examined whether there is an association between thromboembolotic events (TEEs) and concomitant use of dexamethasone with either apixaban or rivaroxaban (both direct oral anticoagulants or DOACs) during treatment for COVID-19. The authors used data from the National COVID Cohort Collaborative (N3C) to conduct a nested case-control study. Eligible participants were adults over 18 years who were exposed to a DOAC for 10 or more consecutive days and exposure to dexamethasone at least 5 or more consecutive days. The study did not find a discernible association of TEE in patients concomitantly exposed to dexamethasone and a DOAC.
AHRQ-funded; HS025984.
Citation: Kravchenko OV, Boyce RD, Gomez-Lumbreras A .
Drug-drug interaction between dexamethasone and direct-acting oral anticoagulants: a nested case-control study in the national COVID cohort collaborative (N3C).
BMJ Open 2022 Dec 29; 12(12):e066846. doi: 10.1136/bmjopen-2022-066846..
Keywords: COVID-19, Blood Thinners, Medication, Adverse Drug Events (ADE), Adverse Events, Cardiovascular Conditions, Medication: Safety, Patient Safety