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Research Studies is a monthly compilation of research articles funded by AHRQ or authored by AHRQ researchers and recently published in journals or newsletters.

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1 to 25 of 111 Research Studies Displayed
Yakovchenko V, Morgan TR, Chinman MJ
Mapping the road to elimination: a 5-year evaluation of implementation strategies associated with hepatitis C treatment in the Veterans Health Administration.
While few countries and healthcare systems are on track to meet the World Health Organization's hepatitis C virus (HCV) elimination goals, the US Veterans Health Administration (VHA) has been a leader in these efforts. In this study the investigators aimed to determine which implementation strategies were associated with successful national viral elimination implementation within the VHA. They conducted a five-year, longitudinal cohort study of the VHA Hepatic Innovation Team (HIT) Collaborative between October 2015 and September 2019.
AHRQ-funded; HS019461.
Citation: Yakovchenko V, Morgan TR, Chinman MJ . Mapping the road to elimination: a 5-year evaluation of implementation strategies associated with hepatitis C treatment in the Veterans Health Administration. BMC Health Serv Res 2021 Dec 18;21(1):1348. doi: 10.1186/s12913-021-07312-4..
View abstract on the National Library of Medicine site.
Keywords: Hepatitis, Chronic Conditions, Veterans
Griffith KN, Asfaw DA, Childers RG
Changes in US veterans' access to specialty care during the COVID-19 pandemic.
This research letter examined changes in US veterans’ access to specialty care during the COVID-19 pandemic through October 2021. The Veterans Health Administration (VHA) completed 14,516,937 internal referrals and purchased an additional 9,904,132 referrals to community-based specialists during the study period. Before the pandemic VHA specialists completed a mean 452,148 referrals each month. Volume dropped starting in March 2020 and did not fully until recover until March 2021. Peak decline was in April 2020 by 70.7% to 132,481 referrals. Community care referrals declined by 32.9% in June 2020, but rebounded thereafter and exceeded the prepandemic baseline by March 2021. Waits for VHA specialists began rising in June 2020, peaked in July 2020 and returned to prepandemic levels by spring 2021. Mean waits for community specialists peaked in June 2020 and returned to prepandemic baseline levels by August 2020.
AHRQ-funded; HS026395.
Citation: Griffith KN, Asfaw DA, Childers RG . Changes in US veterans' access to specialty care during the COVID-19 pandemic. JAMA Netw Open 2022 Sep;5(9):e2232515. doi: 10.1001/jamanetworkopen.2022.32515..
View abstract on the National Library of Medicine site.
Keywords: COVID-19, Veterans, Access to Care
McGinnis KA, Justice AC, Moore RD
Discrimination and calibration of the veterans aging cohort study index 2.0 for predicting mortality among people with human immunodeficiency virus in North America.
Using data from the North American AIDS Cohort Collaboration (NA-ACCORD), the authors translated Veterans Aging Cohort Study (VACS) Index 2.0 scores into validated probability estimates of mortality among people with HIV (PWH). They found that predicted and observed mortality largely overlapped in VACS and the NA-ACCORD subset, overall and within subgroups. Based on this validation, they concluded that VACS Index 2.0 can reliably estimate probability of all-cause mortality, at various follow-up times, among PWH in North America.
AHRQ-funded; 90047713.
Citation: McGinnis KA, Justice AC, Moore RD . Discrimination and calibration of the veterans aging cohort study index 2.0 for predicting mortality among people with human immunodeficiency virus in North America. Clin Infect Dis 2022 Aug 25;75(2):297-304. doi: 10.1093/cid/ciab883..
View abstract on the National Library of Medicine site.
Keywords: Veterans, Human Immunodeficiency Virus (HIV), Chronic Conditions
Feyman Y, Asfaw DA, Griffith KN
Geographic variation in appointment wait times for US military veterans.
The purpose of this cross-sectional study was to examine geographic variation in wait times experienced by veterans for primary care, mental health, and other specialties since the passage of the Veterans Access, Choice, and Accountability Act in 2014 and the VA MISSION (Maintaining Systems and Strengthening Integrated Outside Networks) Act in 2018. These acts allowed veterans to have access to community-based care centers. Data analysis was performed using data from the Veterans Health Administration (VHA) Corporate Data Warehouse. Participants include a final sample of 22,632,918 million appointments for 4,846,892 unique veterans who sought medical care from January 1, 2018, to June 30, 2021. The main outcomes were total appointment wait times in days for the categories of primary care, mental health, and all other specialties. VHA medical centers are organized into regions called Veterans Integrated Services Networks (VISNs); wait times were aggregated to the VISN level. The study found that Among non-VHA appointments, mean VISN-level appointment wait times were 38.9 days for primary care, 43.9 days for mental health, and 41.9 days for all other specialties. Among VHA appointments, mean VISN-level appointment wait times were 29.0 days for primary care, 33.6 days for mental health, and 35.4 days for all other specialties. There was substantial geographic variation in appointment wait times. The researchers concluded that VHA wait times in a majority of VISNs were lower than those for community-based clinicians.
AHRQ-funded; HS026395.
Citation: Feyman Y, Asfaw DA, Griffith KN . Geographic variation in appointment wait times for US military veterans. JAMA Netw Open 2022 Aug;5(8):e2228783. doi: 10.1001/jamanetworkopen.2022.28783..
View abstract on the National Library of Medicine site.
Keywords: Veterans, Access to Care
Ward MJ, Shuster JL, Mohr NM
Implementation of telehealth for psychiatric care in VA emergency departments and urgent care clinics.
The purpose of this AHRQ-funded, mixed-methods study was to evaluate an emergency telehealth intervention in emergency department (ED) and urgent care clinic (UCC) settings within the Veterans Health Administration (VHA) in March 2020. The Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework was utilized to compare the 3 months preimplementation of the telehealth intervention (December 1, 2019 through February 29, 2020) with the 3 months postimplementation of the telehealth intervention (April 1, 2020 through June 30, 2020), and then assess sustainability through January 31, 2021. Qualitative data from surveys and semistructured interviews were conducted and analyze. The telemental health intervention was used in 83% (319) of unscheduled mental health consultations in the postimplementation phase, with no adverse trends in length of stay, 7-day revisits, or 30-day mortality. In the sustainability phase, use of the intervention was high with 82% (n = 1,010) of all unscheduled mental health consultations performed by telemental health. The study concluded that the use of unscheduled telemental health intervention was highly acceptable and sustainable in ED and UCC settings and did not impact the safety and efficacy of mental health consultations.
AHRQ-funded; HS025753.
Citation: Ward MJ, Shuster JL, Mohr NM . Implementation of telehealth for psychiatric care in VA emergency departments and urgent care clinics. Telemed J E Health 2022 Jul;28(7):985-93. doi: 10.1089/tmj.2021.0263..
View abstract on the National Library of Medicine site.
Keywords: COVID-19, Telehealth, Health Information Technology (HIT), Behavioral Health, Emergency Department, Veterans
Danan ER, Brunner J, Bergman A
The relationship between sexual assault history and cervical cancer screening completion among women veterans in the Veterans Health Administration.
The purpose of this study was to determine whether a history of sexual assault in women Veterans is associated with decreased cervical cancer screening completion. The researchers analyzed data from a 2015 survey of 1049 women Veterans who accessed primary care services at 12 Veterans health administration facilities (VA’s) in nine states, and linked responses with electronic health data from the VA system. Fifty-seven percent (616) of women Veterans reported lifetime sexual assault, and those who did so had a greater likelihood of reporting a high level of distress associated with pelvic examinations and delaying a gynecologic exam due to distress. However, in the final adjusted model, there was not a significant association between lifetime sexual assault and reduced odds of cervical cancer screening completion. The study concluded that there was no significant association between sexual assault and gaps in cervical cancer screening completion.
AHRQ-funded; HS026379.
Citation: Danan ER, Brunner J, Bergman A . The relationship between sexual assault history and cervical cancer screening completion among women veterans in the Veterans Health Administration. J Womens Health 2022 Jul;31(7):1040-47. doi: 10.1089/jwh.2021.0237.AHRQ-funded; HS026379..
View abstract on the National Library of Medicine site.
Keywords: Women, Veterans, Cancer: Cervical Cancer, Cancer, Screening, Trauma
Gilmartin HM, Warsavage T, Hines A
Effectiveness of the rural transitions nurse program for veterans: a multicenter implementation study.
This study evaluated the effectiveness of the rural Transitions Nurse Program (TNP), a program to help veterans transferred from rural areas to urban VA Medical Centers for care. A case-control study was conducted from April 2017 to September 2019 with 3001 veterans enrolled in TNP and 6002 matched controls. Interventions were led by a transition nurse who assessed discharge readiness, provided postdischarge communication with primary care providers (PCPs), and called the Veteran within 72 h of discharge home to assess needs, and encouraged follow-up appointment attendance. Controls had no change to their care. Primary outcomes evaluated were PCP visits within 14 days of discharge and all-cause 30-day readmissions, with secondary outcomes 30-day emergency department (ED) visits and 30-day mortality. Patients were matched by their length of stay, prior hospitalizations and PCP visits, urban/rural status, and 32 Elixhauser comorbidities. The veterans enrolled in TNP were more likely to see their PCP within 14 days of discharge than their matched controls. TNP enrollment was not associated with reduced 30-day ED visits or readmissions but was associated with reduced 30-day mortality.
AHRQ-funded; HS024569.
Citation: Gilmartin HM, Warsavage T, Hines A . Effectiveness of the rural transitions nurse program for veterans: a multicenter implementation study. J Hosp Med 2022 Mar;17(3):149-57. doi: 10.1002/jhm.12802..
View abstract on the National Library of Medicine site.
Keywords: Veterans, Rural Health, Transitions of Care, Nursing, Healthcare Delivery
Feyman Y, Auty SG, Tenso K
County-level impact of the COVID-19 pandemic on excess mortality among U.S. veterans: a population-based study.
This study investigated the county-level impact of the COVID-19 pandemic on excess mortality among U.S. veterans. The authors queried Veterans Health Administration (VHA) administrative data on demographics and comorbidities for 11.4 million enrollees during 2016-2020. Eight mortality prediction models at the county-level were used including Poisson, Poisson quasi-likelihood, negative binomial, and generalized estimating equations. All models demonstrated excellent agreement between observed and predicted mortality. An excess mortality rate of 13% in 2020 was found, which corresponds to 50,299 excess deaths. Despite mortality risk factors of veterans, their excess mortality rate was slightly lower than the general population.
AHRQ-funded; HS026395.
Citation: Feyman Y, Auty SG, Tenso K . County-level impact of the COVID-19 pandemic on excess mortality among U.S. veterans: a population-based study. Lancet Reg Health Am 2022 Jan;5:100093. doi: 10.1016/j.lana.2021.100093.
AHRQ-funded; HS026395..
View abstract on the National Library of Medicine site.
Keywords: COVID-19, Veterans, Mortality
Carrel M, Clore GS, Kim S
Health care utilization among Texas Veterans Health Administration enrollees before and after Hurricane Harvey, 2016-2018.
The purpose of this study was to determine how the differential exposure to Hurricane Harvey in August 2017 was associated with changes in utilization of Veterans Health Administration health care. Findings suggested that flood disasters such as Hurricane Harvey may be associated with declines in health care utilization that differ according to flood status, race, and income strata. The patients most exposed to the disaster had the greatest delay or nonreceipt of care.
AHRQ-funded; HS027472.
Citation: Carrel M, Clore GS, Kim S . Health care utilization among Texas Veterans Health Administration enrollees before and after Hurricane Harvey, 2016-2018. JAMA Netw Open 2021 Dec;4(12):e2138535. doi: 10.1001/jamanetworkopen.2021.38535..
View abstract on the National Library of Medicine site.
Keywords: Healthcare Utilization, Veterans, Emergency Department
Ching JH, Owens DK, Trafton JA
Impact of treatment duration on mortality among Veterans with opioid use disorder in the United States Veterans Health Administration.
This study used simulation of a Veterans Health Administration cohort to identify the opioid use disorder (OUD) treatment durations necessary for the elevated mortality risks during treatment transitions balanced by reductions in mortality while receiving medication-assisted treatment (MAT) with methadone or buprenorphine. A simulated cohort of 10,000 individuals with OUD was created by using parameters obtained through calibration and published meta-analyses of studies from North America, Europe, and Australia. Methadone treatment for 4 months or longer or buprenorphine for 2 months or longer resulted in 54 and 65 fewer deaths relative to not receiving MAT for the same duration. The authors estimated shorter treatment durations necessary to achieve net mortality benefits of 2 months or longer for methadone and 1 month or longer for buprenorphine. Necessary treatment increased more with smaller mortality reductions on treatment with larger relative risks during treatment transitions.
AHRQ-funded; HS027935; HS026128.
Citation: Ching JH, Owens DK, Trafton JA . Impact of treatment duration on mortality among Veterans with opioid use disorder in the United States Veterans Health Administration. Addiction 2021 Dec;116(12):3494-503. doi: 10.1111/add.15574.
AHRQ-funded; HS027935; HS026128..
View abstract on the National Library of Medicine site.
Keywords: Opioids, Substance Abuse, Behavioral Health, Veterans, Mortality
Schuttner L, Haraldsson B, Maynard C
Factors associated with low-value cancer screenings in the Veterans Health Administration.
Most clinical practice guidelines recommend stopping cancer screenings when risks exceed benefits, yet low-value screenings persist. The Veterans Health Administration focuses on improving the value and quality of care, using a patient-centered medical home model that may affect cancer screening behavior. The objective of this study was to understand rates and factors associated with outpatient low-value cancer screenings.
AHRQ-funded; HS026369.
Citation: Schuttner L, Haraldsson B, Maynard C . Factors associated with low-value cancer screenings in the Veterans Health Administration. JAMA Netw Open 2021 Oct;4(10):e2130581. doi: 10.1001/jamanetworkopen.2021.30581..
View abstract on the National Library of Medicine site.
Keywords: Veterans, Screening, Value, Cancer
Saffo S, Kaplan DE, Mahmud N
Impact of SGLT2 inhibitors in comparison with DPP4 inhibitors on ascites and death in veterans with cirrhosis on metformin.
Sodium-glucose cotransporter 2 inhibitors (SGLT2i) may have favourable neurohumoral and metabolic effects in patients with chronic liver disease. However, studies examining SGLT2i in this population have been limited to patients with non-alcoholic fatty liver disease and have focused on surrogate biomarkers. The aim of this study was to evaluate whether SGLT2i could reduce the incidence of ascites and death over a period of 36 months in patients with cirrhosis and diabetes mellitus.
AHRQ-funded; HS022882; HS025164.
Citation: Saffo S, Kaplan DE, Mahmud N . Impact of SGLT2 inhibitors in comparison with DPP4 inhibitors on ascites and death in veterans with cirrhosis on metformin. Diabetes Obes Metab 2021 Oct;23(10):2402-08. doi: 10.1111/dom.14488..
View abstract on the National Library of Medicine site.
Keywords: Veterans, Diabetes
Baughman AW, Triantafylidis LK, O'Neil N
Improving medication reconciliation with comprehensive evaluation at a Veterans Affairs skilled nursing facility.
This study described a quality improvement (QI) approach to improve medication reconciliation in a skilled nursing facility (SNF) setting as part of the Multi-Center Medication Reconciliation Quality Improvement Study 2 (MARQUIS2). Findings showed that SNFs represent a critical setting for medication reconciliation efforts due to challenges completing the reconciliation process and the concomitant high risk of adverse drug events in this population. Initial baseline assessments effectively identified existing problems and can be used to guide targeted interventions.
AHRQ-funded; HS023757.
Citation: Baughman AW, Triantafylidis LK, O'Neil N . Improving medication reconciliation with comprehensive evaluation at a Veterans Affairs skilled nursing facility. Jt Comm J Qual Patient Saf 2021 Oct;47(10):646-53. doi: 10.1016/j.jcjq.2021.06.001..
View abstract on the National Library of Medicine site.
Keywords: Medication, Veterans, Quality Improvement, Quality of Care
Wayne MT, Seelye S, Molling D
Temporal trends and hospital variation in time-to-antibiotics among veterans hospitalized with sepsis.
It is unclear whether antimicrobial timing for sepsis has changed outside of performance incentive initiatives. The purpose of this study was to examine temporal trends and variation in time-to-antibiotics for sepsis in the US Department of Veterans Affairs (VA) health care system. The investigators concluded that this cohort study found that time-to-antibiotics for sepsis has declined over time. However, there remained significant variability in time-to-antibiotics not explained by patient characteristics, suggesting potential unwarranted practice variation in sepsis treatment.
AHRQ-funded; HS026725.
Citation: Wayne MT, Seelye S, Molling D . Temporal trends and hospital variation in time-to-antibiotics among veterans hospitalized with sepsis. JAMA Netw Open 2021 Sep 4(9):e2123950. doi: 10.1001/jamanetworkopen.2021.23950..
View abstract on the National Library of Medicine site.
Keywords: Sepsis, Veterans
Akwo EA, Robinson-Cohen C, Chung CP
Association of apparent treatment-resistant hypertension with differential risk of end-stage kidney disease across racial groups in the million veteran program.
Apparent treatment-resistant hypertension (ATRH) has been linked to end-stage kidney disease (ESKD) and cardiovascular disease. In this study, the investigators tested the hypothesis that the effect of ATRH on ESKD is greater in Black patients than in White patients and investigated the effect of ATRH on ESKD independent of APOL1 genotype. The investigators concluded that ATRH was associated with an elevated risk of adverse kidney and cardiovascular outcomes. The effect of ATRH on incident ESKD was magnified among patients with reduced kidney function as well as Black patients, independently of APOL1 genotype.
AHRQ-funded; HS026395.
Citation: Akwo EA, Robinson-Cohen C, Chung CP . Association of apparent treatment-resistant hypertension with differential risk of end-stage kidney disease across racial groups in the million veteran program. Hypertension 2021 Aug;78(2):376-86. doi: 10.1161/hypertensionaha.120.16181..
View abstract on the National Library of Medicine site.
Keywords: Hypertension, Kidney Disease and Health, Racial / Ethnic Minorities, Veterans
Sico JJ, Kundu S, So-Armah K
Depression as a risk factor for incident ischemic stroke among HIV-positive veterans in the veterans aging cohort study.
Background HIV infection and depression are each associated with increased ischemic stroke risk. Whether depression is a risk factor for stroke within the HIV population is unknown. In this study the investigators examined depression as a risk factor for incident ischemic stroke among HIV-positive veterans in the veterans aging cohort study. The investigators concluded that depression is associated with an increased risk of stroke among HIV-positive people after adjusting for sociodemographic characteristics, traditional cerebrovascular risk factors, and HIV-specific factors.
AHRQ-funded; HS023464.
Citation: Sico JJ, Kundu S, So-Armah K . Depression as a risk factor for incident ischemic stroke among HIV-positive veterans in the veterans aging cohort study. J Am Heart Assoc 2021 Jul 6;10(13):e017637. doi: 10.1161/jaha.119.017637..
View abstract on the National Library of Medicine site.
Keywords: Depression, Behavioral Health, Risk, Veterans, Human Immunodeficiency Virus (HIV), Stroke, Cardiovascular Conditions
Caram MEV, Burns J, Kumbier K
Factors influencing treatment of veterans with advanced prostate cancer.
This study examined factors influencing treatment of veterans with metastatic castration-resistant prostate cancer (CRPC). Clinician and nonclinical factors associated with the first-line treatment for CPRC using data from the Veterans Health Administration was used. Almost 5000 patients who received abiraterone, enzalutamide, docetaxel, or ketoconazole from 2010 through 2017 were identified. Increasing age was associated with receipt of abiraterone or enzalutamide versus docetaxel. Greater preexisting comorbidity was associated with enzalutamide versus abiraterone. Patients with higher PSA values at the start of treatment were more likely to receive docetaxel than the other three treatments. African American men were more likely to receive ketoconazole.
AHRQ-funded; HS025707.
Citation: Caram MEV, Burns J, Kumbier K . Factors influencing treatment of veterans with advanced prostate cancer. Cancer 2021 Jul 1;127(13):2311-18. doi: 10.1002/cncr.33485..
View abstract on the National Library of Medicine site.
Keywords: Cancer: Prostate Cancer, Cancer, Veterans, Men's Health, Treatments
Rogal S, Youk A, Agbalajobi O
Medication treatment of active opioid use disorder in veterans with cirrhosis.
Although opioid use disorder (OUD) is common in patients with cirrhosis, it is unclear how medication treatment for OUD (MOUD) is used in this population. In this study, the investigators aimed to assess the factors associated with MOUD and mortality in a cohort of Veterans with cirrhosis and OUD. The investigators found that few Veterans with active OUD and cirrhosis received MOUD, and those with alcohol use disorder, schizophrenia, and previous prescriptions for opioids were least likely to receive these effective therapies.
AHRQ-funded; HS019461.
Citation: Rogal S, Youk A, Agbalajobi O . Medication treatment of active opioid use disorder in veterans with cirrhosis. Am J Gastroenterol 2021 Jul;116(7):1406-13. doi: 10.14309/ajg.0000000000001228..
View abstract on the National Library of Medicine site.
Keywords: Veterans, Opioids, Substance Abuse, Medication
Clair K, Ijadi-Maghsoodi R, Nazinyan M
Veteran perspectives on adaptations to a VA residential rehabilitation program for substance use disorders during the novel coronavirus pandemic.
This paper looks at veterans’ perspectives on adaptations made to a VA residential rehabilitation program for substance use disorders during the novel coronavirus pandemic. Adaptations to services are described within a large residential rehabilitation program for under-resourced veterans; reports veterans’ experiences; and outlines successes and challenges encountered. Data was collected from two focus groups with nine veterans in the program. The groups highlighted experiences of inconsistent communication about residential policies, interruptions to medical and addiction services, and feelings of confinement and social isolation.
AHRQ-funded; HS026407.
Citation: Clair K, Ijadi-Maghsoodi R, Nazinyan M . Veteran perspectives on adaptations to a VA residential rehabilitation program for substance use disorders during the novel coronavirus pandemic. Community Ment Health J 2021 Jul;57(5):801-07. doi: 10.1007/s10597-021-00810-z..
View abstract on the National Library of Medicine site.
Keywords: Veterans, Substance Abuse, Rehabilitation, COVID-19, Healthcare Delivery, Access to Care, Patient Experience
Spalluto LB, Lewis JA, Stolldorf D
Organizational readiness for lung cancer screening: a cross-sectional evaluation at a Veterans Affairs medical center.
Lung cancer has the highest cancer-related mortality in the United States and among Veterans. Screening of high-risk individuals with low-dose CT (LDCT) can improve survival through detection of early-stage lung cancer. Organizational factors that aid or impede implementation of this evidence-based practice in diverse populations are not well described. In this study, the investigators evaluated organizational readiness for change and change valence (belief that change is beneficial and valuable) for implementation of LDCT screening.
AHRQ-funded; HS026395.
Citation: Spalluto LB, Lewis JA, Stolldorf D . Organizational readiness for lung cancer screening: a cross-sectional evaluation at a Veterans Affairs medical center. J Am Coll Radiol 2021 Jun;18(6):809-19. doi: 10.1016/j.jacr.2020.12.010..
View abstract on the National Library of Medicine site.
Keywords: Cancer: Lung Cancer, Cancer, Screening, Veterans, Implementation, Organizational Change
Danan ER, White KM, Wilt TJ
Reactions to recommendations and evidence about prostate cancer screening among White and Black male veterans.
This study looked at differences in attitudes about recommendations and evidence on prostate cancer screening among White and Black male veterans. The authors provided a draft educational pamphlet about the benefits and harms of Prostate Specific Antigen (PSA) screening to 44 men, ages 55-81 at a midwestern VA medical center in 2013 and 2015. The groups were divided into four White and two Black focus groups. Three universal themes were low baseline familiarity with prostate cancer, surprise and resistance to the guidelines not to test routinely, and negative emotions in response to ambiguity. Discussions in the White groups highlighted the potential benefits of screening, minimized the harms, and emphasized personal choice in screening decisions. Discussions in Black groups devoted almost no time to benefits, considered harms significant, and emphasized personal and collective responsibility for cancer prevention through diet, exercise, and alternative medicine. Discussion in Black groups also emphasized the history of racism and discrimination in healthcare and medical research.
AHRQ-funded; HS026379.
Citation: Danan ER, White KM, Wilt TJ . Reactions to recommendations and evidence about prostate cancer screening among White and Black male veterans. Am J Mens Health 2021 May-Jun;15(3):15579883211022110. doi: 10.1177/15579883211022110..
View abstract on the National Library of Medicine site.
Keywords: Veterans, Cancer: Prostate Cancer, Cancer, Screening, Prevention, Racial / Ethnic Minorities, Evidence-Based Practice, Health Promotion, Education: Patient and Caregiver
Dworsky JQ, Shenoy R, Childers CP
Older veterans undergoing inpatient surgery: what is the compliance with best practice guidelines?
This study’s objective was to determine the documented compliance with best practice guidelines for optimal perioperative care for the older adult surgical patient that were created by the American College of Surgeons Quality Improvement Program and the American Geriatrics Society. The guidelines include 38 measures. A retrospective chart review was conducted on 86 older adults undergoing elective inpatient coronary artery bypass graft, prostatectomy, or colectomy over a 2-year period at a single Veterans Affairs hospital. Mean reported compliance across measures was 41% ± 4%. Of the 38 analyzed measures, 10 measures were achieved for 0 patients, and only 1 patient for 7 measures. Future work is needed to understand barriers for implementation.
AHRQ-funded; HS000046.
Citation: Dworsky JQ, Shenoy R, Childers CP . Older veterans undergoing inpatient surgery: what is the compliance with best practice guidelines? Surgery 2021 Feb;169(2):356-61. doi: 10.1016/j.surg.2020.08.033..
View abstract on the National Library of Medicine site.
Keywords: Elderly, Veterans, Surgery, Guidelines, Evidence-Based Practice, Quality Improvement, Quality of Care, Quality Measures
Donnelly JP, Wang XQ, Iwashyna TJ
Readmission and death after initial hospital discharge among patients with COVID-19 in a large multihospital system.
This study describes reasons for readmission, use of intensive care unit (ICU) interventions during readmission, and proportions of death after initial hospital discharge of COVID-19 patients from US Veterans Affairs (VA) hospitals March-June 2020.
AHRQ-funded; HS026725.
Citation: Donnelly JP, Wang XQ, Iwashyna TJ . Readmission and death after initial hospital discharge among patients with COVID-19 in a large multihospital system. JAMA 2021 Jan 19;325(3):304-06. doi: 10.1001/jama.2020.21465.
.
View abstract on the National Library of Medicine site.
Keywords: Respiratory Conditions, COVID-19, Hospital Readmissions, Hospital Discharge, Mortality, Outcomes, Veterans
Lewis JA, Senft N, Chen H
Evidence-based smoking cessation treatment: a comparison by healthcare system.
The authors surveyed general medicine providers and specialists in a large academic health center (AHC) and its affiliated Veterans Health Administration (VHA) in the Mid-South in 2017 to determine the cross-sectional association of healthcare system in which the provider practiced (AHC versus VHA) with self-reported provision of evidence-based smoking cessation treatment at least once in the past 12 months. They found that VHA healthcare providers were significantly more likely to provide evidence-based smoking cessation treatment compared to AHC healthcare providers.
AHRQ-funded; HS026122.
Citation: Lewis JA, Senft N, Chen H . Evidence-based smoking cessation treatment: a comparison by healthcare system. BMC Health Serv Res 2021 Jan 7;21(1):33. doi: 10.1186/s12913-020-06016-5..
View abstract on the National Library of Medicine site.
Keywords: Health Systems, Tobacco Use: Smoking Cessation, Tobacco Use, Evidence-Based Practice, Veterans, Substance Abuse
Bossick AS, Katon JG, Gray KE
Concomitant bilateral salpingo-oophorectomy at hysterectomy: differences by race and menopausal status in the Veterans Affairs health care system, 2007-2014.
This study compared race and menopausal status differences in the rate of concomitant bilateral salphino-oopherectomy (BSO) at hysterectomy in the Veterans Affairs health care system from 2007-2014. The authors identified 6,785 Veterans who underwent a hysterectomy, including 2,230 with concomitant BSO. After adjustment premenopausal Black Veterans had 41% lower odds of going through BSO than their White counterparts. There was insufficient evidence in postmenopausal Veterans. Black Veterans were more likely to be single, obese, and undergo abdominal hysterectomy.
AHRQ-funded; HS013853.
Citation: Bossick AS, Katon JG, Gray KE . Concomitant bilateral salpingo-oophorectomy at hysterectomy: differences by race and menopausal status in the Veterans Affairs health care system, 2007-2014. J Womens Health 2020 Dec;29(12):1513-19. doi: 10.1089/jwh.2020.8503..
View abstract on the National Library of Medicine site.
Keywords: Surgery, Women, Veterans, Racial / Ethnic Minorities

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