National Healthcare Quality and Disparities Report
Latest available findings on quality of and access to health care
Data
- Data Infographics
- Data Visualizations
- Data Tools
- Data Innovations
- All-Payer Claims Database
- Healthcare Cost and Utilization Project (HCUP)
- Medical Expenditure Panel Survey (MEPS)
- AHRQ Quality Indicator Tools for Data Analytics
- State Snapshots
- United States Health Information Knowledgebase (USHIK)
- Data Sources Available from AHRQ
Search All Research Studies
Topics
- Access to Care (8)
- Adverse Events (1)
- Alcohol Use (1)
- Ambulatory Care and Surgery (1)
- Antibiotics (1)
- Antimicrobial Stewardship (1)
- Anxiety (1)
- Behavioral Health (5)
- Blood Pressure (1)
- Cancer (1)
- Cardiovascular Conditions (1)
- Care Coordination (1)
- Children/Adolescents (11)
- Chronic Conditions (1)
- Communication (1)
- Community-Acquired Infections (1)
- Community-Based Practice (2)
- (-) COVID-19 (91)
- Critical Care (4)
- Depression (1)
- Diabetes (2)
- Diagnostic Safety and Quality (1)
- Education (1)
- Education: Academic (1)
- Education: Patient and Caregiver (1)
- Elderly (6)
- Electronic Health Records (EHRs) (2)
- Emergency Department (6)
- Emergency Preparedness (9)
- Evidence-Based Practice (4)
- Family Health and History (1)
- Healthcare-Associated Infections (HAIs) (1)
- Healthcare Cost and Utilization Project (HCUP) (1)
- Healthcare Costs (1)
- Healthcare Delivery (9)
- Healthcare Utilization (3)
- Health Information Exchange (HIE) (1)
- Health Information Technology (HIT) (5)
- Health Literacy (1)
- Health Services Research (HSR) (1)
- Health Systems (1)
- Heart Disease and Health (1)
- Hospital Discharge (1)
- Hospitalization (6)
- Hospital Readmissions (1)
- Hospitals (11)
- Human Immunodeficiency Virus (HIV) (1)
- Infectious Diseases (25)
- Inpatient Care (3)
- Intensive Care Unit (ICU) (5)
- Learning Health Systems (1)
- Long-Term Care (5)
- Low-Income (2)
- Medicaid (2)
- Medical Expenditure Panel Survey (MEPS) (2)
- Medication (2)
- Mortality (5)
- Nursing (1)
- Nursing Homes (8)
- Opioids (2)
- Outcomes (2)
- Patient-Centered Healthcare (1)
- Patient Adherence/Compliance (1)
- Patient Experience (2)
- Patient Safety (2)
- Policy (7)
- Pregnancy (1)
- Prevention (9)
- Primary Care (1)
- Provider (1)
- Provider: Health Personnel (5)
- Provider: Nurse (1)
- Provider: Physician (2)
- (-) Public Health (91)
- Racial and Ethnic Minorities (4)
- Research Methodologies (1)
- Respiratory Conditions (6)
- Risk (10)
- Screening (2)
- Sepsis (1)
- Simulation (1)
- Social Determinants of Health (1)
- Substance Abuse (2)
- Surgery (5)
- Telehealth (2)
- Training (2)
- Transitions of Care (1)
- Vaccination (5)
- Vulnerable Populations (6)
- Women (1)
- Workforce (2)
AHRQ Research Studies
Sign up: AHRQ Research Studies Email updates
Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 25 of 91 Research Studies DisplayedAtkinson 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
MacMartin M, Zeng A, Chelen J
'The burden of wanting to make it right': thematic analysis of semistructured interviews to explore experiences of planning for crisis standards of care and ventilator allocation during the COVID-19 pandemic in the USA.
The objective of this study was to examine the experience of healthcare professionals who created policies for crisis standards of care. Researchers conducted semistructured interviews with healthcare professionals involved in institutional planning for resource shortages in the setting of the COVID-19 pandemic, specifically regarding the allocation of ventilators in the event of a shortage. One overarching theme developed: planning for resource shortages imposed a psychological burden on many planners. Four subthemes that influenced that burden were also identified. The researchers concluded that improved leadership strategies and cross-institutional collaboration can reduce the psychological burden of planning and can facilitate the update of plans in anticipation of future shortages.
AHRQ-funded; HS024075.
Citation: MacMartin M, Zeng A, Chelen J .
'The burden of wanting to make it right': thematic analysis of semistructured interviews to explore experiences of planning for crisis standards of care and ventilator allocation during the COVID-19 pandemic in the USA.
BMJ Open 2023 Nov 9; 13(11):e076674. doi: 10.1136/bmjopen-2023-076674..
Keywords: COVID-19, Public Health, Policy
Kilaru AS, Scheulen JJ, Harbertson CA
Boarding in US academic emergency departments during the COVID-19 pandemic.
The purpose of this retrospective study was to characterize changes in emergency department (ED) boarding among U.S. academic EDs across the duration of the COVID-19 pandemic. From January 2019 to December 2021 the researchers utilized a convenience sample of academic departments of emergency medicine to conduct an analysis of monthly data. The primary outcome was total boarding hours, and secondary outcomes included patient volume stratified by ED disposition. Of the 73 academic departments of emergency medicine contacted, 46.6% participated, a total of 43 individual EDs in 25 states. The study found that the adjusted mean total boarding hours per month were significantly lower during the second quarter of 2020 compared to the first quarter of 2019. Beginning in the second quarter of 2021, total boarding hours were significantly higher than pre-pandemic levels, peaking during the fourth quarter of 2021.
AHRQ-funded; HS026372.
Citation: Kilaru AS, Scheulen JJ, Harbertson CA .
Boarding in US academic emergency departments during the COVID-19 pandemic.
Ann Emerg Med 2023 Sep; 82(3):247-54. doi: 10.1016/j.annemergmed.2022.12.004..
Keywords: COVID-19, Emergency Department, Public Health
Amaefule AQ, Litvintchouk A, de Cordova P
Reevaluating the significance of infection preventionists and infection prevention and control departments in the post-COVID-19 era.
Infection preventionists are specialized health care professionals responsible for infection control policy development and implementation, prevention education for staff and patients, and investigation of outbreaks. The role of infection preventionists in creating effective methods for infection prevention and control became even more critical during the COVID-19 pandemic. The purpose of this paper was to increase awareness of the importance for health care systems and health care institutions to integrate lessons learned, improve infection prevention and control resources, and increase the workforce of infection preventionists to better prepare for pandemic events in the future.
AHRQ-funded; HS029023.
Citation: Amaefule AQ, Litvintchouk A, de Cordova P .
Reevaluating the significance of infection preventionists and infection prevention and control departments in the post-COVID-19 era.
Am J Med Qual 2023 Jul-Aug; 38(4):206-08. doi: 10.1097/jmq.0000000000000132..
Keywords: COVID-19, Infectious Diseases, Public Health
Patel M, Berlin H, Rajkumar A
Barriers to telemedicine use: qualitative analysis of provider perspectives during the COVID-19 pandemic.
The objective of this study was to describe perceived barriers and facilitators to the use of web-based visits to inform quality improvement efforts and promote sustainability. Medical providers at a large, midwestern academic institution were surveyed. Four overarching categories of provider experience with web-based visits emerged: quality of care, patient rapport, visit flow, and equity. The authors concluded that their findings demonstrated key barriers to the maintenance of telemedicine services following the COVID pandemic, and that these findings might help to prioritize impactful methods of sustaining and expanding telemedicine availability for patients.
AHRQ-funded; HS027632.
Citation: Patel M, Berlin H, Rajkumar A .
Barriers to telemedicine use: qualitative analysis of provider perspectives during the COVID-19 pandemic.
JMIR Hum Factors 2023 Jun 26; 10:e39249. doi: 10.2196/39249..
Keywords: Telehealth, COVID-19, Public Health, Health Information Technology (HIT), Provider: Health Personnel
Mahmud A, Cushing-Haugen K, Wellman R
Understanding the relationship between social risk factors and COVID-19 contacts.
The purpose of this study was to facilitate researchers’ understanding of the prevalence of patients' social risk factors during the pandemic and recognize how social risks may intensify COVID-19. Between January and September 2020, the researchers conducted a national survey of Kaiser Permanente members and analyzed only the data from those who responded to a set of COVID-19 survey items. The survey included questions on their experiences with social risks, whether they knew of people with COVID-19, if COVID-19 affected their emotional and mental health, and their preferred type of assistance. The study found that 62% of respondents reported social risks, with 38% reporting having 2 or more social risks. The most common response was financial strain (45%). One third of respondents reported one or more contact types with COVID-19. respondents with 2 or more COVID-19 contact types reported higher rates of housing instability, financial strain, food insecurity, and social isolation than those with fewer contacts. Fifty percent of respondents reported that COVID-19 affected their emotional, mental health negatively, and 19% of respondents noted that it affected their ability to maintain a job.
AHRQ-funded; HS013853.
Citation: Mahmud A, Cushing-Haugen K, Wellman R .
Understanding the relationship between social risk factors and COVID-19 contacts.
Perm J 2023 Jun 15; 27(2):18-22. doi: 10.7812/tpp/22.146..
Keywords: COVID-19, Risk, Public Health, Infectious Diseases
Mooney AC, Jackson KE, Hamad R
Experiences of distress and gaps in government safety net supports among parents of young children during the COVID-19 pandemic: a qualitative study.
This study examined the experiences and challenges of families with low incomes caring for young children during the COVID-19 pandemic. The authors conducted semi-structured qualitative interviews from August 2020 to January 2021 with 34 parents of young children in California that were then analyzed using thematic analysis. They identified three key themes related to parents' experiences during the pandemic: (1) positive experiences with government support programs, (2) challenging experiences with government support programs, and (3) distress resulting from insufficient support for childcare disruptions. Program expansions helped alleviate food insecurity, and those attending community colleges reported accessing a range of supports through supportive counselors. However, there were many reported gaps in childcare and distance learning support, pre-existing housing instability, and parenting stressors.
AHRQ-funded; HS022241.
Citation: Mooney AC, Jackson KE, Hamad R .
Experiences of distress and gaps in government safety net supports among parents of young children during the COVID-19 pandemic: a qualitative study.
BMC Public Health 2023 Jun 7; 23(1):1099. doi: 10.1186/s12889-023-16037-4..
Keywords: Children/Adolescents, COVID-19, Public Health
Acolin J, Fishman P
Beyond the biomedical, towards the agentic: a paradigm shift for population health science.
Life expectancy in the United States is decreasing. Health disparities are widening. Growing evidence for and integration of social and structural determinants into theory and practice has not yet improved outcomes. The COVID-19 pandemic reinforced the fact. The purpose of this paper was to contend that the biomedical model and its core scientific paradigm of causal determinism, is unable to meet population health needs. The researchers offer that this paper advances the field of medicine by transcending criticism to recognize the need for a paradigm shift. The authors apply the experience of the COVID-19 pandemic to exemplify the practical applications of their framework.
AHRQ-funded; HS013853.
Citation: Acolin J, Fishman P .
Beyond the biomedical, towards the agentic: a paradigm shift for population health science.
Soc Sci Med 2023 Jun; 326:115950. doi: 10.1016/j.socscimed.2023.115950..
Keywords: COVID-19, Public Health
Jenkins JL, Hsu EB, Zhang A
Current evidence for infection prevention and control interventions in emergency medical services: a scoping review.
This study’s aim was to summarize current evidence from the United States on the effectiveness of practices and interventions for preventing, recognizing, and controlling occupationally acquired infectious diseases in Emergency Medical Service (EMS) clinicians. A database search was conducted for literature published January 2006 through March 15, 2022 to search for studies in the United States that involved EMS clinicians and firefighters, reported on one or more workplace practices or interventions that prevented or controlled infectious diseases, and included outcome measures. Eleven observational studies reported on infection prevention and control (IPC) practices providing evidence that hand hygiene, standard precautions, mandatory vaccine policies, and on-site vaccine clinics are effective. Less frequent handwashing and less frequent hand hygiene after glove use were positively correlated with nasal colonization of Methicillin-resistant Staphylococcus aureus (MRSA). Lack of personal protective equipment (PPE) or PPE breach were correlated with higher severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) seropositivity and virus 2 (SARS-CoV-2) seropositivity. Workers were more likely to be vaccinated against influenza if their employer offered the vaccine. Vaccination rates for H1N1 influenza increased with the use of active, targeted education modules.
AHRQ-funded; 75Q80120D00003.
Citation: Jenkins JL, Hsu EB, Zhang A .
Current evidence for infection prevention and control interventions in emergency medical services: a scoping review.
Prehosp Disaster Med 2023 Jun; 38(3):371-77. doi: 10.1017/s1049023x23000389..
Keywords: COVID-19, Emergency Department, Evidence-Based Practice, Prevention, Public Health, Infectious Diseases
AA Payán, DD Brown, TT
AHRQ Author: Tierney
Telehealth use, care continuity, and quality: diabetes and hypertension care in community health centers before and during the COVID-19 pandemic.
In a cohort study, researchers examined the association of care continuity with diabetes and hypertension care quality in community health centers (CHCs) before and during COVID-19, and the mediating effect of telehealth. Patients with diabetes and/or hypertension with at least 2 encounters per year during 2019 and 2020 were identified via electronic health record data from 166 CHCs; multivariable logistic regression models estimated the association of care continuity with telehealth use and care processes. The results showed that higher care continuity was associated with telehealth use and A1c testing, and lower A1c and blood pressure. The researchers concluded that care continuity might facilitate telehealth use and resilient performance on process measures.
AHRQ-funded; HS022241.
Citation: AA Payán, DD Brown, TT .
Telehealth use, care continuity, and quality: diabetes and hypertension care in community health centers before and during the COVID-19 pandemic.
Med Care 2023 Apr 1;61(Suppl 1):S62-s69. doi: 10.1097/mlr.0000000000001811.
Keywords: COVID-19, Telehealth, Health Information Technology (HIT), Diabetes, Blood Pressure, Community-Based Practice, Public Health
Blebu BE, Kuppermann M, Coleman-Phox K
A qualitative exploration of experiences accessing community and social services among pregnant low-income people of color during the COVID-19 pandemic.
The COVID-19 pandemic has led to heightened social and economic stressors for expectant individuals. Although community and social services exist to alleviate stressors during pregnancy (e.g., food insecurity and financial difficulties) and decrease the likelihood of negative maternal outcomes, it remains uncertain how the pandemic influenced access to these resources, especially among low-income communities of color. The purpose of this study was to explore the experiences of low-income pregnant individuals of color in accessing community and social service resources during the COVID-19 pandemic. This qualitative study on COVID-related factors recruited participants from two sources—a prospective comparative effectiveness study comparing two enhanced prenatal care models and the California Black Infant Health Program between August and November 2020. The researchers conducted 62 interviews with Medicaid-eligible participants in California's Central Valley, asking them to describe their pregnancy-related experiences and the perceived impact of the pandemic on these experiences. The study identified two overarching themes: obstacles in accessing community and social service resources during the pandemic and potential avenues for enhancing access to these resources. Sub-themes regarding challenges encountered encompassed issues with remote access, complex registration procedures for community and social services, and concerns specific to COVID-19 resources (e.g., testing). Sub-themes associated with opportunities for improved access included capitalizing on instrumental support from perinatal staff and informational (e.g., practical) support from other community programs and pregnant peers. Participants suggested improved client experiences could be achieved through increased transparency and enhanced patient-provider communication.
AHRQ-funded; HS026407
Citation: Blebu BE, Kuppermann M, Coleman-Phox K .
A qualitative exploration of experiences accessing community and social services among pregnant low-income people of color during the COVID-19 pandemic.
Womens Health 2023 Jan-Dec;19:17455057231156792. doi: 10.1177/17455057231156792.
Keywords: COVID-19, Racial and Ethnic Minorities, Low-Income, Women, Pregnancy, Public Health
Auty SG, Aswani MS, Wahbi RN
Changes in health care access by race, income, and Medicaid expansion during the COVID-19 pandemic.
This study examined changes in access to care during the COVID-19 pandemic, stratified by race/ethnicity, household income, and state Medicaid expansion status. Data were extracted for all adults (N = 1,731,699) aged 18-64 surveyed in the 2015-2020 Behavioral Risk Factor Surveillance System from all 50 states and the District of Columbia. The pandemic was associated with a 1.2 percentage point decline in uninsurance for Medicaid expansion states, with reductions concentrated among respondents who were Black, multiracial, or low income. Rates of uninsurance were generally stable in nonexpansion states. Rates of avoided care because of cost fell by 3.5 percentage points in Medicaid expansion states, and by 3.6 percentage points in nonexpansion states. These declines were also concentrated among minority or low-income respondents.
AHRQ-funded; HS026395.
Citation: Auty SG, Aswani MS, Wahbi RN .
Changes in health care access by race, income, and Medicaid expansion during the COVID-19 pandemic.
Med Care 2023 Jan;61(1):45-49. doi: 10.1097/mlr.0000000000001788..
Keywords: COVID-19, Access to Care, Medicaid, Public Health, Racial and Ethnic Minorities, Low-Income
Sirkin JT, Flanagan E, Tong ST
AHRQ Author: Tong ST, McNellis RJ, Bierman AS
Primary care's challenges and responses in the face of the COVID-19 pandemic: insights from AHRQ's learning community.
The purpose of this paper was to review the Agency for Healthcare Research and Quality’s (AHRQ) learning community organized to engage and support primary care in responding to COVID-19 and provide an opportunity for participants to communicate learning and peer support, improve understanding of the stressors and challenges faced by practices, determine needs, and identify possible solutions to challenges of the pandemic. The researchers identified challenges, responses, and innovations that occurred through the engagement and information sharing of the learning community and categorized them across 5 domains, including: patient-centeredness, clinician and practice, systems and infrastructure, community and public health; and health equity which cut across each of the other domains. The authors concluded that the learning community provided valuable insights for future research and policy, primary care delivery improvement, and ensuring greater preparedness for future challenges.
AHRQ-authored.
Citation: Sirkin JT, Flanagan E, Tong ST .
Primary care's challenges and responses in the face of the COVID-19 pandemic: insights from AHRQ's learning community.
Ann Fam Med 2023 Jan-Feb; 21(1):76-82. doi: 10.1370/afm.2904..
Keywords: COVID-19, Primary Care, Learning Health Systems, Health Systems, Evidence-Based Practice, Public Health
Meyer AND, Singh H, Zimolzak AJ
Cancer evaluations during the COVID-19 pandemic: an observational study using National Veterans Affairs data.
This observational study examined the reasons why fewer cancer diagnoses have been made during the COVID-19 pandemic using electronic health record data from the Department of Veterans Affairs before (March 10, 2019-March 7, 2020) and during (March 8, 2020-March 6, 2021) the pandemic. Electronic triggers were applied to 8,021,406 veterans' electronic health records to identify follow-up delays for abnormal results warranting evaluation for 5 cancers: bladder, breast, colorectal, liver, and lung cancers. Between the prepandemic and pandemic periods, test quantities decreased by 12.6%-27.8%, and proportions of abnormal results lacking follow-up decreased for urinalyses by 0.8%, increased by 2.3% for fecal occult blood tests/fecal immunochemical test and 1.8% for chest imaging, and remained constant for the other diagnostic tests (mammograms for breast cancer and elevated alpha-fetoprotein for liver cancer). This significant decrease in diagnostic testing may have led to reduced cancer rates.
AHRQ-funded; HS027363.
Citation: Meyer AND, Singh H, Zimolzak AJ .
Cancer evaluations during the COVID-19 pandemic: an observational study using National Veterans Affairs data.
Am J Prev Med 2022 Dec;63(6):1026-30. doi: 10.1016/j.amepre.2022.07.004..
Keywords: COVID-19, Cancer, Public Health
Crnich CJ
Reimagining infection control in U.S. nursing homes in the era of COVID-19.
This paper provides an overview of nursing home (NH) infection and control, reviews the 2016 CMS changes to federal regulations, and proposes recommendations to sustain improvements. COVID-19 put further pressure on nursing homes who were already strained by rising numbers of infections from C. difficile and multidrug-resistant organisms. The author puts out a call for reimagining infection prevention and control using the Systems Engineering Initiative for Patient Safety framework. Additional recommendations are made to enhance NH infection prevention and control programs in the areas of people, tasks, tools, organization, built environment, and external environment.
AHRQ-funded; HS022465.
Citation: Crnich CJ .
Reimagining infection control in U.S. nursing homes in the era of COVID-19.
J Am Med Dir Assoc 2022 Dec;23(12):1909-15. doi: 10.1016/j.jamda.2022.10.022..
Keywords: Elderly, COVID-19, Public Health, Infectious Diseases, Nursing Homes, Healthcare-Associated Infections (HAIs), Prevention
Shover CL, Rosen A, Mata J
Engaging same-day peer ambassadors to increase coronavirus disease 2019 vaccination among people experiencing unsheltered homelessness in Los Angeles County: a hybrid feasibility-evaluation study.
This study’s goal was to evaluate the feasibility and acceptability of engaging unhoused peer ambassadors (PAs) in COVID-19 vaccination efforts to reach people experiencing unsheltered homelessness in Los Angeles County. A total of 117 PAs were enrolled at 103 events, participating for an average of 2 hours. Findings showed that 197 additional people were vaccinated over 167 PA hours, accounting for >25% of all vaccines given at these events, indicating that recruiting same-day unhoused PAs is a feasible, acceptable, and preliminarily effective technique to increase COVID-19 vaccination in unsheltered settings.
AHRQ-funded; HS026407.
Citation: Shover CL, Rosen A, Mata J .
Engaging same-day peer ambassadors to increase coronavirus disease 2019 vaccination among people experiencing unsheltered homelessness in Los Angeles County: a hybrid feasibility-evaluation study.
J Infect Dis 2022 Oct 7;226(suppl 3):S346-s52. doi: 10.1093/infdis/jiac291..
Keywords: COVID-19, Vaccination, Vulnerable Populations, Public Health
Richmond J, Sanderson M, Shrubsole MJ
Psychosocial impact of COVID-19 among adults in the southeastern United States.
The authors investigated factors associated with depressive and anxiety symptoms during the COVID-19 pandemic. Using data from the Southern Community Cohort Study (SCCS), their results overall suggested that individuals in fair/poor health, living alone, and/or experiencing decreased physical activity and vegetable/fruit consumption have higher risk of depressive and anxiety symptoms. They recommended clinical and public health interventions to support individuals experiencing depression and anxiety during the COVID-19 pandemic.
AHRQ-funded; HS026122.
Citation: Richmond J, Sanderson M, Shrubsole MJ .
Psychosocial impact of COVID-19 among adults in the southeastern United States.
Prev Med 2022 Oct;163:107191. doi: 10.1016/j.ypmed.2022.107191..
Keywords: COVID-19, Anxiety, Depression, Behavioral Health, Public Health
Shankar LG, Habich M, Rosenman M
Mental health emergency department visits by children before and during the COVID-19 pandemic.
Investigators described pediatric mental health emergency department (ED) visit rates and visit characteristics before and during the COVID-19 pandemic. They found that mental health ED visit rates by children increased during the COVID-19 pandemic.
AHRQ-funded; HS026385.
Citation: Shankar LG, Habich M, Rosenman M .
Mental health emergency department visits by children before and during the COVID-19 pandemic.
Acad Pediatr 2022 Sep-Oct;22(7):1127-32. doi: 10.1016/j.acap.2022.05.022..
Keywords: COVID-19, Children/Adolescents, Emergency Department, Behavioral Health, Healthcare Utilization, Public Health
Adams C, Chamberlain A, Wang Y
The role of staff in transmission of SARS-CoV-2 in long-term care facilities.
The purpose of this study was to assess the role of long-term care facility (LTCF) staff in transmission of the SARS-CoV-2 virus. From March 2020 to September the researchers evaluated residents and staff of 60 LTCFs in Georgia. The study found that after vaccines were first distributed to LTCFs in December 202, case counts, outbreak size and duration, and time-varying reproduction number [R(t)] declined rapidly. Staff cases were six times more infectious than resident cases, and unvaccinated resident cases were more infectious than vaccinated resident cases. The researchers concluded that staff were the primary drivers of COVID-19 transmission in LTCFs and vaccines slowed the transmission of the virus and contributed to a reduction in cases in LTCFs.
AHRQ-funded; HS025987.
Citation: Adams C, Chamberlain A, Wang Y .
The role of staff in transmission of SARS-CoV-2 in long-term care facilities.
Epidemiology 2022 Sep 1;33(5):669-77. doi: 10.1097/ede.0000000000001510..
Keywords: COVID-19, Respiratory Conditions, Long-Term Care, Public Health
Jin DP, Samuel S, Bowden K
Just-in-time electronic health record retraining to support clinician redeployment during the COVID-19 surge.
The purpose of this study was to examine the use of training in ICU-specific electronic health record (EHR) workflows prior to redeployment of certified registered nurse anesthetists (CRNAs) as ICU clinicians during the COVID-19 surge. The researchers utilized clinical informatics (CI) fellows to lead a multidisciplinary team to deploy a customized HER curriculum consisting of in-person classes and online video modules. Eighteen CRNAs participated, with 15 completing surveys immediately after the in-person training session, and 12 participants completing a post-deployment survey. The study found that all respondents of the post-training survey thought the training was useful and improved their EHR skills. Of the 12 participants who completed the post-deployment survey, all said that the training both increased their comfort in the ICU and that the concepts learned would be useful in their anesthesia role, and 91% indicated the training prepared them to work in the ICU with minimal guidance. The researchers concluded that CI fellows are uniquely prepared to deliver EHR training for clinician deployment in operational crisis response.
AHRQ-funded; HS02373.
Citation: Jin DP, Samuel S, Bowden K .
Just-in-time electronic health record retraining to support clinician redeployment during the COVID-19 surge.
Appl Clin Inform 2022 Aug 29;13(5):949-55. doi: 10.1055/a-1933-1798..
Keywords: COVID-19, Electronic Health Records (EHRs), Health Information Technology (HIT), Public Health, Training, Workforce
Guo W, Li Y, Temkin-Greener H
Coronavirus disease 2019 (COVID-19) in assisted living communities: neighborhood deprivation and state social distancing policies matter.
Investigators examined the association between COVID-19 cases in assisted living communities (ALCs) and the proportion of Medicare-Medicaid (dual) eligible minority residents, neighborhood area deprivation, and state COVID-19 policy stringency. They found that ALCs with higher proportions of dual-eligible minority residents were more likely to have COVID-19 outbreaks within their communities. Further, ALCs located in more socioeconomically deprived neighborhoods, and in states with less stringent state social distancing policies, tended to have more COVID-19 cases.
AHRQ-funded; HS026893.
Citation: Guo W, Li Y, Temkin-Greener H .
Coronavirus disease 2019 (COVID-19) in assisted living communities: neighborhood deprivation and state social distancing policies matter.
Infect Control Hosp Epidemiol 2022 Aug;43(8):1004-09. doi: 10.1017/ice.2022.46..
Keywords: COVID-19, Elderly, Long-Term Care, Policy, Public Health
Adams C, Wortley P, Chamberlain A
Declining COVID-19 case-fatality in Georgia, USA, March 2020 to March 2021: a sign of real improvement or a broadening epidemic?
This article examined whether declines in the crude US COVID-19 case fatality ratio is due to improved clinical care and/or other factors. The authors used multivariable logistic regression to examine associations between report month and mortality among confirmed and probable COVID-19 cases and hospitalized cases in Georgia from March 2020 through March 2021. Mortality risk was lowest in November 2020 compared to August 2020 and remained lower until March 2021. Among hospitalized cases, mortality risk increased in December 2020 and January 2021 before declining in March 2021. The authors concluded that improved clinical management may have contributed to lower mortality risk.
AHRQ-funded; HS025987.
Citation: Adams C, Wortley P, Chamberlain A .
Declining COVID-19 case-fatality in Georgia, USA, March 2020 to March 2021: a sign of real improvement or a broadening epidemic?
Ann Epidemiol 2022 Aug;72:57-64. doi: 10.1016/j.annepidem.2022.05.008..
Keywords: COVID-19, Public Health, Mortality
Cutler GJ, Bergmann KR, Doupnik SK
Pediatric mental health emergency department visits and access to Inpatient care: a crisis worsened by the COVID-19 pandemic.
The purpose of this study was to explore the author’s previous research findings on trends in pediatric emergency department (ED) visits for mental health (MH) vs non-mental health in light of more recent related data corresponding with the COVID-19 pandemic. The study found that recent research supports the dramatic increase in pediatric MH ED visits found in the author’s previous research and provides additional evidence that the increase has been driven by specific MH diagnoses. The researchers conclude that depressive disorders, self-harm behavior, and non-alcohol substance use disorders should be prioritized for the development of ED- and hospital-based strategies, and that EDs, hospitals, health systems, and the government urgently need to increase capacity for MH services and identify innovative solutions to improve access to high quality MH care for children.
AHRQ-funded; HS026385.
Citation: Cutler GJ, Bergmann KR, Doupnik SK .
Pediatric mental health emergency department visits and access to Inpatient care: a crisis worsened by the COVID-19 pandemic.
Acad Pediatr 2022 Aug;22(6):889-91. doi: 10.1016/j.acap.2022.03.015..
Keywords: Children/Adolescents, COVID-19, Behavioral Health, Emergency Department, Access to Care, Public Health, Inpatient Care
Keller SC, Caballero TM, Tamma PD
AHRQ Author: Miller MA
Assessment of changes in visits and antibiotic prescribing during the Agency for Healthcare Research and Quality Safety Program for Improving Antibiotic Use and the COVID-19 pandemic.
This cohort study evaluated the effectiveness of the AHRQ Safety Program for Improving Antibiotic Use aimed to improve antibiotic prescribing in ambulatory practices by engaging clinicians and staff to incorporate antibiotic stewardship into practice culture, communication, and decision-making. The study ran from December 2019 through November 2020. A total of 389 ambulatory care practices with over 6.5 million visits to 5483 clinicians were compared from the baseline to completion of the program. Participants included 82 primary care practices, 103 urgent care practices, 34 federally supported practices, 21 pediatric-only practices, 39 pediatric urgent care practices, 21 pediatric-only practices, and 14 other practice types. Of the 389 practices who completed the program, 75% submitted completed data. Visits per practice per month decreased from a mean of 1624 at baseline to a nadir of 906 early in the COVID-19 pandemic (April 2020) and were 1797 at the end of the program. Total antibiotic prescribing decreased from 18.2% of visits at baseline to 9.5% at completion of the program. Acute respiratory infection (ARI) visits per practice per month decreased from a baseline of 321 to a nadir of 76 early in the pandemic (May 2020) and gradually increased through completion of the program (n = 239). Antibiotic prescribing for ARIs decreased from 39.2% at baseline to 24.7% at completion of the program.
AHRQ-authored; AHRQ-funded; 233201500020I.
Citation: Keller SC, Caballero TM, Tamma PD .
Assessment of changes in visits and antibiotic prescribing during the Agency for Healthcare Research and Quality Safety Program for Improving Antibiotic Use and the COVID-19 pandemic.
JAMA Netw Open 2022 Jul;5(7):e2220512. doi: 10.1001/jamanetworkopen.2022.20512..
Keywords: Antimicrobial Stewardship, Antibiotics, Medication, COVID-19, Public Health, Respiratory Conditions