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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.
Results1 to 25 of 190 Research Studies Displayed
Hails KA, Petts RA, Hostutler CA
COVID-19 distress, negative parenting, and child behavioral problems: the moderating role of parent adverse childhood experiences.
This study’s objective was to test a moderated mediation model to determine whether families’ COVID-19-related distress is associated with young children's emotional/behavioral functioning via negative parenting, and whether these relationships vary based on parents' adverse childhood experiences (ACEs). Participants were 267 parents recruited from five primary care sites across the United States with children ages 1.5-5 years. Internet questionnaires were completed on measures including demographics, parent ACEs, negative parenting, parent mental health, and COVID-19 distress. Negative parenting significantly mediated the relationship between COVID-19 distress and child emotional/behavioral problems. The model accounted for 42% variance in child emotional/behavioral problems.
Citation: Hails KA, Petts RA, Hostutler CA . COVID-19 distress, negative parenting, and child behavioral problems: the moderating role of parent adverse childhood experiences. Child Abuse Negl 2022 Aug;130(Pt 1):105450. doi: 10.1016/j.chiabu.2021.105450..
Keywords: Children/Adolescents, COVID-19, Behavioral Health, Stress
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.
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
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
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.
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..
Keywords: COVID-19, Telehealth, Health Information Technology (HIT), Behavioral Health, Emergency Department, Veterans
Zeng W, Jarawan E, Bajnauth D
AHRQ Author: Ding Y
COVID-19 and global mental health service delivery and financing.
The purpose of this AHRQ-authored letter was to characterize the state of global mental health needs, service delivery, and financing as a result of the COVID-19 pandemic. The authors report that the mental health aftermath of the COVID-19 pandemic will likely be extended in duration and will both compound and deepen the social and economic disruptions that were already taking place prior to the pandemic. The authors conclude that the integration of mental health initiatives into both international and national emergency response strategies and public health strategies is important as governments enhance mental health service delivery and financing as a critical component of building more inclusive and resilient postpandemic health systems.
Citation: Zeng W, Jarawan E, Bajnauth D . COVID-19 and global mental health service delivery and financing. Public Health 2022 Jun;207:127-28. doi: 10.1016/j.puhe.2022.04.005..
Keywords: COVID-19, Healthcare Delivery, Behavioral Health
Semere W, Makaroun LK, Beach S
Family caregivers navigating the health care system: evolving roles during the COVID-19 pandemic.
The purpose of this study was to explore changes in the ways family caregivers assisted family members with chronic illness and disability in addressing their health care needs during the COVID-19 pandemic. The researchers administered telephone and online surveys to family caregivers who were listed in a regional research registry, asking them what level of helping they provided during the pandemic compared to the level they were providing prior to the pandemic. The study found that of the 561caregivers that responded to the survey, 59% reported an increase in providing help with 1 or more heath care activities. The researchers advise that for caregivers assisting vulnerable patients to access care, support strategies should be considered by the health system and health care providers.
Citation: Semere W, Makaroun LK, Beach S . Family caregivers navigating the health care system: evolving roles during the COVID-19 pandemic. Fam Syst Health 2022 Jun;40(2):268-73. doi: 10.1037/fsh0000688..
Keywords: Caregiving, COVID-19, Chronic Conditions
Andino JJ, Zhu Z, Surapaneni M
Interstate telehealth use by Medicare beneficiaries before and after COVID-19 licensure waivers, 2017-20.
This study analyzed trends in interstate telehealth use by Medicaid beneficiaries during 2017-2020, which covers the period both directly before and during the first year of the pandemic. Although the volume of interstate telehealth use increased in 2020, out-of-state telehealth only made up 0.8% of all outpatient visits, and 5% of all telehealth visits overall. For individual states, out-of-state telehealth made up between 0.2-9.3% of all outpatient visits. Most out-of-state telehealth visits were used for established patient care, and a higher percentage of out-of-state telehealth users lived in rural areas compared with beneficiaries who stayed with in-state care (28% versus 23%).
Citation: Andino JJ, Zhu Z, Surapaneni M . Interstate telehealth use by Medicare beneficiaries before and after COVID-19 licensure waivers, 2017-20. Health Aff 2022 Jun;41(6):838-45. doi: 10.1377/hlthaff.2021.01825.
Keywords: Telehealth, COVID-19, Health Information Technology (HIT), Medicare, Healthcare Delivery
Valley TS, Schutz A, Peltan ID
Organization of outpatient care after COVID-19 hospitalization.
The purpose of this study was to describe post-discharge care delivery for patients with postacute sequelae of COVID-19 (PASC) across a large network of US academic and community hospitals. Beginning in July, 2021, the researchers surveyed 47 hospitals which were participating in the National Heart, Lung, and Blood Institute Clinical Trials Network for the Prevention and Early Treatment of Acute Lung Injury (PETAL Network.) Surveys were completed by physicians, hospital administrators, social workers, research staff or other clinicians over an 8-week period, and data from the 2019 American Hospital Association annual survey database were used to describe the hospitals. The study found that 79% (37) of the responding hospitals provided COVID-specific discharge information to patients hospitalized with COVID-19. Only 26% of hospitals provided discharge information that included potential symptoms or impairments of postacute sequelae of COVID-19. Seventy percent (33) had a PASC clinic (a postdischarge outpatient clinic designed specifically for patients with COVID). Hospitals without PASC clinics were more likely to be located in a ZIP code with a higher Medicare population and a median annual income lower than $40,000, and were also more likely to be smaller, for-profit hospitals. The researchers identified several core areas for possible improvements in PASC care, including: examining the impact of PASC clinics on patient outcomes; assessing the extent to which the pathophysiology and management of PASC differ from sequelae of other infections and syndromes; and exploring whether an inability to systematically identify patients for PASC care may result in an inability for some patients to receive needed care. The researchers concluded that PASC clinics may offer opportunities to coordinate care and serve as an opportunity for making iterative gains in knowledge about PASC clinics and related models and processes and their effectiveness in improving longer-term patient-centered outcomes for survivors of COVID-19.
Citation: Valley TS, Schutz A, Peltan ID . Organization of outpatient care after COVID-19 hospitalization. Chest 2022 Jun;161(6):1485-89. doi: 10.1016/j.chest.2022.01.034..
Keywords: COVID-19, Ambulatory Care and Surgery, Hospitalization, Care Coordination, Healthcare Delivery
Petts RA, Walker BL, Hails KA
Parents' preferences for behavioral services in primary care during the COVID-19 pandemic.
The purpose of the study was to evaluate whether the COVID-19 pandemic impacted parent’s preferences and priorities for receiving behavioral health services for their young children in the pediatric primary care setting. In 5 pediatric primary care sites across the U.S., between July 2020 and January 2021, 301 parents of young children completed surveys on their preferences for behavioral subjects and methods of service delivery in primary care. The responses were compared to the responses from 396 parents who had been surveyed on the same measures in 2018. The study concluded that priorities for behavioral subjects during the pandemic were similar to parent’s priorities before the pandemic, with only one behavioral subject (child self-calming) rated significantly more important by the parents in the pandemic group than the pre-pandemic parents. The parents in the pandemic group were also significantly more interested in remote and media-based services such as mobile applications and videos than parents in the pre-pandemic group. The researchers conclude that pediatric primary care practices may wish to consider providing mobile apps, videos, and/ or other multimedia resources as part of their behavioral health services practices.
Citation: Petts RA, Walker BL, Hails KA . Parents' preferences for behavioral services in primary care during the COVID-19 pandemic. J Dev Behav Pediatr 2022 Jun-Jul;43(5):291-96. doi: 10.1097/dbp.0000000000001033..
Keywords: Children/Adolescents, COVID-19, Behavioral Health, Primary Care
Dube WC, Kellogg JT, Adams C
Quantifying risk for SARS-CoV-2 infection among nursing home workers for the 2020-2021 winter surge of the COVID-19 pandemic in Georgia, USA.
This study’s objective was to estimate incidence of risks for COVID-19 infection among nursing home staff in the state of Georgia during the 2020-2021 Winter surge in the US. Staff at fourteen nursing homes were given a survey and serologic testing at 2 time points with 3-month interval exposure assessment. At the first time point, 203 study eligible contracted or employed staff members from these participating nursing homes were seronegative. At the second time point, 72 (35.5%) had evidence of interval infection. Among unvaccinated staff, infection rates were significantly higher among nurses and certified nursing assistants accounting for race and interval infection incidence in both the community and facility.
Citation: Dube WC, Kellogg JT, Adams C . Quantifying risk for SARS-CoV-2 infection among nursing home workers for the 2020-2021 winter surge of the COVID-19 pandemic in Georgia, USA. J Am Med Dir Assoc 2022 Jun;23(6):942-46.e1. doi: 10.1016/j.jamda.2022.02.014..
Keywords: COVID-19, Nursing Homes, Provider: Health Personnel, Risk, Public Health
Usher MC, Tignanelli CJ, Hilliard B
Responding to COVID-19 through interhospital resource coordination: a mixed-methods evaluation
Researchers sought to describe a novel hospital system approach to managing the COVID-19 pandemic, including multihospital coordination capability and transfer of COVID-19 patients to a single, dedicated hospital. They found that, with standardized communication, interhospital transfers were a safe and effective method of cohorting COVID-19 patients, were well-received by health care providers, and had the potential to improve care quality.
AHRQ-funded; HS026379; HS026732.
Citation: Usher MC, Tignanelli CJ, Hilliard B . Responding to COVID-19 through interhospital resource coordination: a mixed-methods evaluation J Patient Saf 2022 Jun 1;18(4):287-94. doi: 10.1097/pts.0000000000000916..
Keywords: COVID-19, Hospitals, Healthcare Delivery, Public Health, Care Coordination, Transitions of Care
Evans LV, Ray JM, Bonz JW
Improving patient and clinician safety during COVID-19 through rapidly adaptive simulation and a randomised controlled trial: a study protocol.
The purpose of this study will be to simultaneously assess the challenges and facilitators of COVID-19 preparedness in the emergency department (ED) and the mitigation of emergency physician stress, test the effectiveness of a simulation preparedness intervention on physician physiological stress, and improve physician preparedness while decreasing physician stress and anxiety.
Citation: Evans LV, Ray JM, Bonz JW . Improving patient and clinician safety during COVID-19 through rapidly adaptive simulation and a randomised controlled trial: a study protocol. BMJ Open 2022 May 19;12(5):e058980. doi: 10.1136/bmjopen-2021-058980..
Keywords: COVID-19, Patient Safety, Simulation, Burnout, Provider: Clinician
Michelson KA, Samuels-Kalow ME
Association of elementary school reopening status and county COVID-19 incidence.
This study examined the association between elementary school opening status (ESOS) and pediatric COVID-19 incidence. The authors conducted a cross-sectional study of US counties with school districts with ≥500 elementary school students. The main exposure was ESOS in September 2020 and outcome was county incidence of COVID-19. Among 3220 US counties, 19.2% were remote, 12.1% were hybrid, and 62.8% were in person. In unadjusted models, COVID-19 incidence after school started was higher among children in hybrid or in-person counties compared with remote only counties. After adjusting for local COVID-19 incidence, the incidence rate ratio compared with remote counties was 1.01 in hybrid counties and 0.79 in in-person counties.
Citation: Michelson KA, Samuels-Kalow ME . Association of elementary school reopening status and county COVID-19 incidence. Acad Pediatr 2022 May-Jun;22(4):667-70. doi: 10.1016/j.acap.2021.09.006..
Keywords: Children/Adolescents, COVID-19, Public Health, Education
Lowry KP, Bissell MCS, Miglioretti DL
Breast biopsy recommendations and breast cancers diagnosed during the COVID-19 pandemic.
The authors sought to examine breast biopsy recommendations and breast cancers diagnosed before and during the COVID-19 pandemic by mode of detection and women's characteristics. Using data from the Breast Cancer Surveillance Consortium, they found that there were substantially fewer breast biopsies with cancer diagnoses during the COVID-19 pandemic from March to September 2020 compared to the same period in 2019, with Asian and Hispanic women experiencing the largest declines followed by Black women.
Citation: Lowry KP, Bissell MCS, Miglioretti DL . Breast biopsy recommendations and breast cancers diagnosed during the COVID-19 pandemic. Radiology 2022 May;303(2):287-94. doi: 10.1148/radiol.2021211808..
Keywords: COVID-19, Cancer: Breast Cancer, Cancer, Diagnostic Safety and Quality
Schmutz KE, Wallace AS, Bristol AA
Hospital discharge during COVID-19: the role of social resources.
The purpose of this qualitative study was to examine the effect of the COVID-19 pandemic on the ability of patients to obtain and receive support post-discharge after medical or surgical hospital services. The researchers utilized the Individual and Family Self-Management Theory as a framework for semi-structured interviews conducted with 26 patients discharged from the hospital. The study found that the majority of participants described minimal impact on their ability to secure support, with the exception of one participant whose support changes radically affected her experience post-discharge. The researchers concluded that strong pre-existing social support networks were protective for patients returning home after hospitalization during the pandemic.
Citation: Schmutz KE, Wallace AS, Bristol AA . Hospital discharge during COVID-19: the role of social resources. Clin Nurs Res 2022 May;31(4):724-32. doi: 10.1177/10547738221075760..
Keywords: COVID-19, Hospital Discharge, Hospitals
Kranz AM, Steiner ED, Mitchell JM
School-based health services in Virginia and the COVID-19 pandemic.
The purpose of this study was to examine how the COVID-19 pandemic may have impacted the provision of school health services and related student needs. In May 2021, all 1178 Virginia public elementary schools received a web-based survey regarding the impact of the pandemic on school-based health services, with 65% of schools responding (N=767). Schools reported providing fewer school-based health services during the pandemic than before, with dental screenings declining the most (51% before vs 15% after). The study also reported that mental health as a top concern for students increased from 15% before the pandemic to 27% during the pandemic. The study concluded that schools reported providing fewer health services to students during pandemic in the 2020-2021 school year and increased concern about students' mental health.
Citation: Kranz AM, Steiner ED, Mitchell JM . School-based health services in Virginia and the COVID-19 pandemic. J Sch Health 2022 May;92(5):436-44. doi: 10.1111/josh.13147..
Keywords: COVID-19, Children/Adolescents, Public Health, Healthcare Delivery, Community-Based Practice
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.
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
AHRQ Author: Huppert J
Adolescents with vulvar ulcers: COVID-19 disease, COVID-19 vaccines, and the value of case reports.
The author indicates that there are too few cases reporting aphthosis after COVID disease or COVID-19 vaccination to infer a statistical association, but that case reports are a valuable source of rich details about conditions that are difficult to study with more rigorous designs and can be synthesized to help guide medical care. She recommends that it is time for a high-quality systematic review of vulvar aphthosis in order for clinicians to incorporate the existing evidence into decision-making and best care for patients.
Citation: Huppert J . Adolescents with vulvar ulcers: COVID-19 disease, COVID-19 vaccines, and the value of case reports. J Pediatr Adolesc Gynecol 2022 Apr;35(2):109-11. doi: 10.1016/j.jpag.2022.01.006..
Keywords: Children/Adolescents, COVID-19, Vaccination, Research Methodologies
Berger AC, Simchoni N, Auerbach A
Implementation of clinical practice guidelines for hospitalized patients with COVID-19 in academic medical centers.
This study was a survey of members of the Hospital Medicine Reengineering Network to determine the rate at which US academic medical centers have adopted evidence-based practice guidelines for COVID-19. Of 83 hospitals contacted, 53 responded. Fifty-one sites issued internal COVID-19 management guidance. Guidance types included for infectious disease (98%), infection control (90%), hospital medicine (88%) and critical care (83%). Of the 51 sites with internal COVID-19 management guidance, recommendations were most commonly disseminated through email, institutional websites, and integration into electronic health records as COVID-19-specific order sets and note templates. Three themes emerged from the researcher’s analysis. First, translation from evidence to practice guidelines was remarkably complete for interventions supported by aligned national guidelines and high-quality studies. Second, institutions favored treatment over not treatment, particularly when guidelines diverged from each other. Lastly, academic medical centers demonstrated a willingness to innovate across a range of interventions.
Citation: Berger AC, Simchoni N, Auerbach A . Implementation of clinical practice guidelines for hospitalized patients with COVID-19 in academic medical centers. JAMA Netw Open 2022 Apr;5(4):e225657. doi: 10.1001/jamanetworkopen.2022.5657..
Keywords: COVID-19, Guidelines, Inpatient Care
Chen J, Li KY, Andino J
Predictors of audio-only versus video telehealth visits during the COVID-19 pandemic.
During the Covid-19 pandemic, most health insurance companies reimbursed telehealth visits; both video and audio-only (i.e., phone). Post-pandemic many of these organizations may discontinue coverage for phone visits, yet the impact of doing so on different patient subgroups is not clear. The purpose of this study was to identify the patient subgroups that are more likely to use phone vs video to access telehealth services. The researchers conducted a retrospective study on a cohort of all patients at a United States medical center who had a telehealth-eligible outpatient visit from April 2020 through June 2020. The primary measure was the effect of patient geographic, demographic, and socioeconomic characteristics on the probability of phone visits vs video visits. The study found that of the 104,204 total patients with at least one telehealth visit, 45.4% received their care through phone visits only. Patient age, being African American, needing an interpreter, having Medicaid as their primary insurance, and living in a zip code with low broadband access were all characteristics associated with a lower likelihood of using video visits. In addition, the majority of patients had more than one characteristic which further reduced their likelihood of using video visits. The study concluded that patients with the characteristics identified are less likely to use video visits when compared to phone visits. The researchers state that for patients with one or more of those characteristics, elimination of insurance coverage for telehealth phone visits may decrease telehealth access.
Citation: Chen J, Li KY, Andino J . Predictors of audio-only versus video telehealth visits during the COVID-19 pandemic. J Gen Intern Med 2022 Apr;37(5):1138-44. doi: 10.1007/s11606-021-07172-y..
Keywords: COVID-19, Telehealth, Health Information Technology (HIT)
Huang J, Graetz I, Millman A
Primary care telemedicine during the COVID-19 pandemic: patient's choice of video versus telephone visit.
The goal of this study was to examine the association between patient characteristics and primary care telemedicine choice among integrated delivery system patients self-scheduling visits during the COVID-19 pandemic. Findings showed that patients of Black or Hispanic race/ethnicity, or living in low socioeconomic status or low internet access neighborhoods were less likely to schedule video visits. Also, patients 65 years or older, with prior video visit experience or mobile portal access, or visiting their own personal provider were more likely to schedule video visits. While video adoption was substantial in all patient groups examined, differences in telemedicine choice suggested the persistence of a digital divide.
Citation: Huang J, Graetz I, Millman A . Primary care telemedicine during the COVID-19 pandemic: patient's choice of video versus telephone visit. JAMIA Open 2022 Apr;5(1):ooac002. doi: 10.1093/jamiaopen/ooac002..
Keywords: COVID-19, Primary Care, Telehealth, Health Information Technology (HIT), Access to Care
Murray E, Roosevelt GE, Vogel JA
Screening for health-related social needs in the emergency department: adaptability and fidelity during the COVID-19 pandemic.
Researchers sought to evaluate a screening and referral program for health-related social needs (HRSN) in an emergency department. Using the Accountable Health Communities Screening Tool, they found that, during the COVID-19 pandemic, HRSN doubled, likely reflecting the economic impact of the pandemic.
Citation: Murray E, Roosevelt GE, Vogel JA . Screening for health-related social needs in the emergency department: adaptability and fidelity during the COVID-19 pandemic. Am J Emerg Med 2022 Apr;54:323.e1-23.e4. doi: 10.1016/j.ajem.2021.09.071..
Keywords: COVID-19, Social Determinants of Health, Emergency Department, Screening, Public Health
Behr CL, Joynt Maddox KE, Meara E
Anti-SARS-CoV-2 monoclonal antibody distribution to high-risk Medicare beneficiaries, 2020-2021.
The authors assessed how the limited supply of monoclonal antibodies (mAbs) therapy was allocated to patients at highest risk of severe disease. They found that, among non-hospitalized Medicare beneficiaries with a COVID-19 diagnosis between November 2020 and August 2021, only 7.2% received mAb therapy. In many cases, patients at the highest risk of severe disease were the least likely to receive mAb therapy, with extreme variation geographically. Their analysis did not account for patient vaccination status or observed disease severity, which could influence clinicians’ decisions.
Citation: Behr CL, Joynt Maddox KE, Meara E . Anti-SARS-CoV-2 monoclonal antibody distribution to high-risk Medicare beneficiaries, 2020-2021. JAMA 2022 Mar 8;327(10):980-83. doi: 10.1001/jama.2022.1243..
Keywords: COVID-19, Medicare, Medication
Bartsch SM, O'Shea KJ, Chin KL
Maintaining face mask use before and after achieving different COVID-19 vaccination coverage levels: a modelling study.
This study’s objective was to assess the value of maintaining face mask use indoors according to different COVID-19 vaccination coverage levels in the US. This computational simulation-model study used a Monte Carlo simulation model representing the US population and SARS CoV-2 spread. The investigation found that maintaining face mask use until and a short time after achieving various final vaccination coverage levels can not only be cost-effective, but even cost saving. In all scenarios, it was estimated cost-effective to maintain face mask use for about 2-10 weeks beyond the date of target vaccination coverage achievement.
Citation: Bartsch SM, O'Shea KJ, Chin KL . Maintaining face mask use before and after achieving different COVID-19 vaccination coverage levels: a modelling study. Lancet Public Health 2022 Mar 8;7(4):e356-e65. doi: 10.1016/s2468-2667(22)00040-8..
Keywords: COVID-19, Public Health
Woloshin S, Dewitt B, Krishnamurti T
Assessing how consumers interpret and act on results from at-home COVID-19 self-test kits: a randomized clinical trial.
The US Food and Drug Administration (FDA) authorized SARS-CoV-2 rapid at-home self-test kits for individuals with and without symptoms. How appropriately users interpret and act on the results of at-home COVID-19 self-tests is unknown. The objective of this study was to assess how users of at-home COVID-19 self-test kits interpreted and acted on results when given instructions authorized by the FDA, instructions based on decision science principles, or no instructions.
Citation: Woloshin S, Dewitt B, Krishnamurti T . Assessing how consumers interpret and act on results from at-home COVID-19 self-test kits: a randomized clinical trial. JAMA Intern Med 2022 Mar;182(3):332-41. doi: 10.1001/jamainternmed.2021.8075..
Keywords: COVID-19, Diagnostic Safety and Quality