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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 13 of 13 Research Studies DisplayedRao S, Armistead I, Tyler A
Respiratory syncytial virus, influenza, and coronavirus disease 2019 hospitalizations in children in Colorado during the 2021-2022 respiratory virus season.
This study compared demographic characteristics, clinical features, and outcomes of children hospitalized with respiratory syncytial virus (RSV), influenza, or severe acute respiratory syndrome coronavirus 2 during their cocirculation 2021-2022 respiratory virus season. The authors conducted a retrospective cohort study using Colorado's hospital respiratory surveillance data comparing coronavirus disease 2019 (COVID-19)-, influenza-, and RSV-hospitalized cases < 18 years of age admitted and undergoing standardized molecular testing between October 1, 2021, and April 30, 2022. The cohort consisted of 847 hospitalized cases, of which 490 (57.9%) were RSV associated, 306 (36.1%) were COVID-19 associated, and 51 (6%) were influenza associated. Most RSV cases were children less than 4 years of age (92.9%), whereas influenza hospitalizations were observed in older children. RSV cases were more likely to require oxygen support higher than nasal cannula compared with COVID-19 and influenza cases, although COVID-19 cases were more likely to require invasive mechanical ventilation than influenza and RSV cases. Compared with children with COVID-19, the risk of intensive care unit admission was highest among children with influenza, whereas the risk of pneumonia, bronchiolitis, longer hospital length of stay, and need for oxygen were more likely among children with RSV.
AHRQ-funded; HS026512.
Citation: Rao S, Armistead I, Tyler A .
Respiratory syncytial virus, influenza, and coronavirus disease 2019 hospitalizations in children in Colorado during the 2021-2022 respiratory virus season.
J Pediatr 2023 Sep; 260:113491. doi: 10.1016/j.jpeds.2023.113491..
Keywords: Children/Adolescents, COVID-19, Respiratory Conditions, Influenza, Hospitalization, Infectious Diseases
Encinosa W, Figueroa J, Elias Y
AHRQ Author: Encinosa W
Severity of hospitalizations from SARS-CoV-2 vs influenza and respiratory syncytial virus infection in children aged 5 to 11 years in 11 US states.
By the time emergency use authorization had been granted for the Pfizer-BioNTech vaccine in October 2021 in children aged 5 to 11 years, there had been 1.8 million diagnoses of SARS-CoV-2 infection, 8,000 hospitalizations, and 143 deaths in that age group. Very little has been reported on the severity of those hospitalizations relative to the influenza virus and respiratory syncytial virus (RSV) which are the most common childhood viruses. The purpose of this study was to compare hospitalizations of children aged 5 to 11 for SARS-CoV-2 infection and multisystem inflammatory system in children (MIS-C, a sequela of COVID-19 disease) with the hospitalizations of children aged 5 to 11 years who were infected with influenza and RSV. The researchers utilized inpatient data from the Agency for Healthcare Research and Quality (AHRQ) Healthcare Cost and Utilization Project from the first 11 states with complete first-quarter data as of October 2021, representing 24% of the US population of children aged 5 to 11 years. The researchers examined 46 complications in 7 body systems, total care costs and charges, and data on race and ethnicity. The resulting cross-sectional study included patient data from a total of 2,269 children. The study found that COVID-19 hospitalizations occurred at the rate of 10.8 per 100,000 children, while Influenza and RSV were rare during the first quarter of 2021 with 23 total hospital discharges combined. However, in 2017, which researchers also measured for data on influenza and RSV, influenza and RSV had 17.0 and 6.2 hospitalizations per 100,000 children, respectively. Inpatient death for all viruses was rare. MIS-C had the highest rates of cardiovascular, hematologic, and gastrointestinal complications. Children with RSV ha the highest rate of respiratory complications. Children with COVID-19 (without MISC-C) had the highest rate of neurologic complications, whereas children with influenza had the highest rate of muscoskeletal complications. Children with MIS-C had the longest median length of stay at a median cost of $23,585 per stay compared to children with influenza with a median length of stay of 2 days and a cost of $5,200.
AHRQ-authored.
Citation: Encinosa W, Figueroa J, Elias Y .
Severity of hospitalizations from SARS-CoV-2 vs influenza and respiratory syncytial virus infection in children aged 5 to 11 years in 11 US states.
JAMA Pediatr 2022 May;176(5):520-22. doi: 10.1001/jamapediatrics.2021.6566..
Keywords: Healthcare Cost and Utilization Project (HCUP), COVID-19, Children/Adolescents, Hospitalization, Influenza, Respiratory Conditions
Hofstetter AM, Opel DJ, Stockwell MS
Associations between health care professional communication practices and influenza vaccination of hospitalized children.
The objective of this study was to describe the communication of health care professionals (HCPs) with parents of hospitalized children concerning the influenza vaccine. A survey was conducted online or via telephone with English- and Spanish-speaking parents of influenza vaccine-eligible children hospitalized at a pediatric hospital after discharge. Findings showed that a parent-reported HCP conversation and recommendation were associated with influenza vaccination during hospitalization.
AHRQ-funded; HS025470.
Citation: Hofstetter AM, Opel DJ, Stockwell MS .
Associations between health care professional communication practices and influenza vaccination of hospitalized children.
Acad Pediatr 2021 Sep-Oct;21(7):1142-50. doi: 10.1016/j.acap.2021.06.014..
Keywords: Children/Adolescents, Influenza, Vaccination, Communication, Health Promotion, Clinician-Patient Communication
Hofstetter AM, Opel DJ, Stockwell MS
Influenza-related knowledge, beliefs, and experiences among caregivers of hospitalized children.
Caregivers frequently decline influenza vaccine for their hospitalized child. In this study, the investigators aimed to examine factors impacting their influenza vaccine decision-making. The investigators conducted a cross-sectional survey study of English- and Spanish-speaking caregivers of children hospitalized at a tertiary care pediatric hospital between November 2017 and April 2018.They identified key factors impacting influenza vaccine decision-making among caregivers of hospitalized children, a critical step to improving uptake in this population.
AHRQ-funded; HS025470.
Citation: Hofstetter AM, Opel DJ, Stockwell MS .
Influenza-related knowledge, beliefs, and experiences among caregivers of hospitalized children.
Hosp Pediatr 2021 Aug;11(8):815-32. doi: 10.1542/hpeds.2020-003459..
Keywords: Children/Adolescents, Caregiving, Influenza, Vaccination
Orenstein EW, ElSayed-Ali O, Kandaswamy S
Evaluation of a clinical decision support strategy to increase seasonal influenza vaccination among hospitalized children before inpatient discharge.
The authors’ goal was to design and evaluate a clinical decision support (CDS) strategy to increase the proportion of eligible hospitalized children who receive a seasonal influenza vaccine prior to inpatient discharge. They found that a user-centered CDS may be associated with significantly improved influenza vaccination rates among hospitalized children.
AHRQ-funded; HS027689.
Citation: Orenstein EW, ElSayed-Ali O, Kandaswamy S .
Evaluation of a clinical decision support strategy to increase seasonal influenza vaccination among hospitalized children before inpatient discharge.
JAMA Netw Open 2021 Jul;4(7):e2117809. doi: 10.1001/jamanetworkopen.2021.17809..
Keywords: Children/Adolescents, Influenza, Vaccination, Clinical Decision Support (CDS), Health Information Technology (HIT), Hospital Discharge
Goldstein E, Finelli L, O'Halloran A
AHRQ Author: Karaca Z, Steiner C
Hospitalizations associated with respiratory syncytial virus and influenza in children, including children diagnosed with asthma.
This study examined hospitalization rates in children associated with respiratory syncytial virus (RSV) and influenza, including children with asthma. HCUP hospitalization data and additional data to estimate RSV and influenza-associated hospitalization with a respiratory cause was analyzed in different subpopulations of US children between 2003 and 2010. Annual rates of RSV-associated hospitalization was highest in infants and young children, and declined rapidly with age. Influenza hospitalizations also were highest in young children and declined by age 12-17 years. Higher rates of RSV-related and influenza hospitalization in the youngest children with a prior diagnosis of asthma was also found.
AHRQ-authored.
Citation: Goldstein E, Finelli L, O'Halloran A .
Hospitalizations associated with respiratory syncytial virus and influenza in children, including children diagnosed with asthma.
Epidemiology 2019 Nov;30(6):918-26. doi: 10.1097/ede.0000000000001092..
Keywords: Healthcare Cost and Utilization Project (HCUP), Children/Adolescents, Asthma, Influenza, Respiratory Conditions, Hospitalization, Chronic Conditions
Feemster K, Localio R, Grundmeier R
Incidence of healthcare-associated influenza-like illness after a primary care encounter among young children.
The authors evaluated whether exposure to a pediatric clinic visit was associated with subsequent influenza-like illness (ILI) using electronic health record data. They found that pediatric clinic visits during a respiratory virus season were significantly associated with an increased incidence of subsequent ILI among children aged 2 to 6 years but not among those aged less than 2 years. They concluded that their findings support the hypothesis that respiratory virus transmission in a pediatric clinic can result in healthcare-associated ILI in young children.
AHRQ-funded; HS020939.
Citation: Feemster K, Localio R, Grundmeier R .
Incidence of healthcare-associated influenza-like illness after a primary care encounter among young children.
J Pediatric Infect Dis Soc 2019 Jul 1;8(3):191-96. doi: 10.1093/jpids/piy023..
Keywords: Children/Adolescents, Healthcare-Associated Infections (HAIs), Infectious Diseases, Influenza, Primary Care, Healthcare Delivery, Ambulatory Care and Surgery, Respiratory Conditions
Yoo BK, Schaffer SJ, Humiston SG
Cost effectiveness of school-located influenza vaccination programs for elementary and secondary school children.
This paper describes a clinical trial which created a school-located influenza vaccination (SLIV) program in upstate New York. Researchers wanted to determine if this was a cost-effective alternative to vaccination in primary care practices. Two groups of students were vaccinated – one in an elementary school and the other in a secondary school. Secondary school vaccinations were more cost-effective than elementary schools with a lower median cost per vaccination. The authors concluded that it does raise vaccination rates, but it is not cost-effective due to the higher costs for consent systems and project coordination.
AHRQ-funded; HS021163.
Citation: Yoo BK, Schaffer SJ, Humiston SG .
Cost effectiveness of school-located influenza vaccination programs for elementary and secondary school children.
BMC Health Serv Res 2019 Jun 24;19(1):407. doi: 10.1186/s12913-019-4228-5..
Keywords: Children/Adolescents, Education, Healthcare Costs, Influenza, Public Health, Vaccination
Schaffer SJ, Rand CM, Humiston SG
Practical considerations in developing a successful school-located influenza vaccination (SLIV) program.
This paper discussed strategies in developing a successful school-located influenza vaccination (SLIV) program. The authors indicate that adequate planning is crucial for SLIV success. In addition, they delineate several components that are important for a SLIV program to be successful: 1. Buy-in from school districts and school nurses, 2. Timing of SLIV clinics, 3. Publicizing SLIV to parents, 4. Obtaining vaccination consent, 5. Adequacy of resources, 6. Billing, and 7. Sustainability
AHRQ-funded; HS021163.
Citation: Schaffer SJ, Rand CM, Humiston SG .
Practical considerations in developing a successful school-located influenza vaccination (SLIV) program.
Vaccine 2019 Apr 10;37(16):2171-73. doi: 10.1016/j.vaccine.2019.01.088..
Keywords: Vaccination, Influenza, Infectious Diseases, Children/Adolescents
Szilagyi PG, Schaffer S, Rand CM
Text message reminders for child influenza vaccination in the setting of school-located influenza vaccination: a randomized clinical trial.
This study assessed whether text message reminders to parents could raise rates for children receiving school-located influenza vaccination (SLIV). Researchers randomized families with children in urban elementary schools to receive either text message plus SLIV (intervention) or SLIV alone (comparison). All parents were also sent two ‘backpack’ notifications and two autodialer phone reminders about SLIV at a single SLIV clinic. The text message reminders did not raise influenza vaccination rates above those observed with SLIV alone, and the authors conclude that more intensive interventions are needed to raise influenza vaccination rates.
AHRQ-funded; HS021163.
Citation: Szilagyi PG, Schaffer S, Rand CM .
Text message reminders for child influenza vaccination in the setting of school-located influenza vaccination: a randomized clinical trial.
Clin Pediatr 2019 Apr;58(4):428-36. doi: 10.1177/0009922818821878..
Keywords: Children/Adolescents, Influenza, Health Information Technology (HIT), Vaccination
Szilagyi PG, Schaffer S, Rand CM
School-located influenza vaccinations for adolescents: a randomized controlled trial.
In this study, the investigators aimed to evaluate the effect of school-located influenza vaccination (SLIV) on adolescents' influenza vaccination rates. In 2015-2016, they performed a cluster-randomized trial of adolescent SLIV in middle/high schools. They concluded that SLIV in this community increased influenza vaccination rates among adolescents attending suburban schools.
AHRQ-funded; HS021163.
Citation: Szilagyi PG, Schaffer S, Rand CM .
School-located influenza vaccinations for adolescents: a randomized controlled trial.
J Adolesc Health 2018 Feb;62(2):157-63. doi: 10.1016/j.jadohealth.2017.09.021..
Keywords: Children/Adolescents, Education, Influenza, Prevention, Public Health, Vaccination
Lee GE, Fisher BT, Xiao R
Burden of influenza-related hospitalizations and attributable mortality in pediatric acute lymphoblastic leukemia.
The researchers investigated the rate of influenza hospitalizations and attributable mortality in children with cancer. They concluded that the burden of influenza-related hospitalizations in children with acute lymphoblastic leukemia is high and associated with significantly increased resource utilization and attributable mortality.
AHRQ-funded; HS020939.
Citation: Lee GE, Fisher BT, Xiao R .
Burden of influenza-related hospitalizations and attributable mortality in pediatric acute lymphoblastic leukemia.
J Pediatric Infect Dis Soc 2015 Dec;4(4):290-6. doi: 10.1093/jpids/piu066..
Keywords: Children/Adolescents, Hospitalization, Influenza, Mortality, Children/Adolescents
Humiston SG, Poehling KA, Szilagyi PG
School-located influenza vaccination: can collaborative efforts go the distance?
This commentary discusses school-located influenza vaccination during the school day and includes the survey results from Kempe et al., in the same issue. The authors conclude that increasing influenza vaccination rates will require vaccinating “outside the box,” utilizing a site in which school-aged youth already tend to congregate.
AHRQ-funded; HS021163.
Citation: Humiston SG, Poehling KA, Szilagyi PG .
School-located influenza vaccination: can collaborative efforts go the distance?
Acad Pediatr 2014 May-Jun;14(3):219-20. doi: 10.1016/j.acap.2014.03.004.
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Keywords: Children/Adolescents, Influenza, Vaccination