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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
101 to 125 of 12392 Research Studies DisplayedFredericksen RJ, Baker R, Sibley A
Motivation and context of concurrent stimulant and opioid use among persons who use drugs in the rural United States: a multi-site qualitative inquiry.
Semi-structured interviews with 349 people who use drugs (PWUD) in rural U.S. areas revealed a high prevalence of concurrent stimulant and opioid use. Methamphetamine was the most common stimulant used (78%). Participants identified various reasons for co-use, including changes in drug markets, recreational goals, and practical goals like managing opioid overdose or withdrawal symptoms. Some also reported using stimulants for functional purposes, such as increasing energy and reducing pain to maintain employment. This study highlights the need for targeted education, harm reduction services, and treatment options specifically addressing combined opioid and stimulant use in rural areas.
AHRQ-funded; HS026370.
Citation: Fredericksen RJ, Baker R, Sibley A .
Motivation and context of concurrent stimulant and opioid use among persons who use drugs in the rural United States: a multi-site qualitative inquiry.
Harm Reduct J 2024 Apr 1; 21(1):74. doi: 10.1186/s12954-024-00986-z..
Keywords: Opioids, Rural Health, Substance Abuse, Behavioral Health, Rural/Inner-City Residents
Liu T, Zhu Z, Holmgren AJ
National trends in billing patient portal messages as e-visit services in traditional Medicare.
This study examined trends in billing patient portal messages in traditional Medicare. In 2020 the Centers for Medicare & Medicaid Services introduced online digital evaluation and management (E&M) codes for clinicians to address patient concerns asynchronously through patient portal messages. The authors identified e-visit services for 100% Medicare fee-for-service population from 2020 through 2022. Billing for e-visit services reached a peak of 728 monthly encounters per 100,000 beneficiaries during the initial onset of the COVID pandemic and stabilized to approximately 90 monthly encounters per 100,000 beneficiaries. Primary care provided billing more frequently than other specialties, accounting for over 50% of all billed e-visits during the study period. Fewer beneficiaries lived in rural areas compared with beneficiaries using telehealth and in-person care, but otherwise shared similar demographic characteristics. Hypertension was the most common diagnosis (21%), followed by diabetes (2.3%) and COVID-19 (2%).
AHRQ-funded; HS028397.
Citation: Liu T, Zhu Z, Holmgren AJ .
National trends in billing patient portal messages as e-visit services in traditional Medicare.
Health Affairs Scholar 2024 Apr; 2(4):qxae040. doi: 10.1093/haschl/qxae040..
Keywords: Telehealth, Health Information Technology (HIT), Medicare, COVID-19
Yellowlees PM, Burke MM, Gonzalez AD
Patient and provider satisfaction with asynchronous versus synchronous telepsychiatry in primary care: a secondary mixed-methods analysis of a randomized controlled trial.
This mixed-methods study was a secondary analysis of patients' and primary care providers' (PCPs) satisfaction from a randomized clinical trial that compared asynchronous telepsychiatry (ATP) with synchronous telepsychiatry (STP). Patients and PCPs completed a satisfaction survey and provided unstructured feedback about their experiences with either ATP or STP. Patients expressed overall satisfaction with both STP and ATP, although patients in ATP reported more concerns about the process. PCPs showed no preference for STP or ATP, and reported implementing psychiatrists' recommendations for both groups when recommendations were made.
AHRQ-funded; HS021477.
Citation: Yellowlees PM, Burke MM, Gonzalez AD .
Patient and provider satisfaction with asynchronous versus synchronous telepsychiatry in primary care: a secondary mixed-methods analysis of a randomized controlled trial.
Telemed J E Health 2024 Apr; 30(4):e1049-e63. doi: 10.1089/tmj.2023.0238..
Keywords: Telehealth, Health Information Technology (HIT), Primary Care, Behavioral Health
Scott HF, Lindberg DM, Brackman S
Pediatric sepsis in general emergency departments: association between pediatric sepsis case volume, care quality, and outcome.
The purpose of this study was to evaluate whether a general emergency department's (ED) annual pediatric sepsis volume increases the odds of delivering care aligned with Surviving Sepsis pediatric guidelines. The researchers included 1,527 ED encounters between January 1, 2015, and September 30, 2021. The study found that care was aligned with the guidelines in 41.1% of encounters, and annual pediatric sepsis volume was minimally related with the probability of guideline-concordant care. Care concordance increased from 23.1% in 2015 to 52.8% in 2021.
AHRQ-funded; HS025696.
Citation: Scott HF, Lindberg DM, Brackman S .
Pediatric sepsis in general emergency departments: association between pediatric sepsis case volume, care quality, and outcome.
Ann Emerg Med 2024 Apr; 83(4):318-26. doi: 10.1016/j.annemergmed.2023.10.011..
Keywords: Children/Adolescents, Sepsis, Emergency Department, Quality of Care, Guidelines, Evidence-Based Practice
Collins ME, Hall M, Shah SS
Phlebotomy-free days in children hospitalized with common infections and their association with clinical outcomes.
This study looked at the association of clinical outcomes of phlebotomy-free days (PFDs) in children hospitalized with common infections. The authors performed a cross-sectional study of children hospitalized 2018-2019 with common infections at 38 hospitals using the Pediatric Health Information System database. They included infectious All Patients Refined Diagnosis Related Groups with a median length of stay (LOS) >2 days. They defined PFDs as hospital days (midnight to midnight) without laboratory blood testing and measured the proportion of PFDs divided by total hospital LOS (PFD ratio) for each condition and hospital. The higher the PDF ratio, the more days without phlebotomy. They identified 126,135 encounters with bronchiolitis (0.78) and pneumonia (0.54) having the highest PDF ratios, while osteoarticular infections (0.28) and gastroenteritis (0.30) having the lowest PDF ratios. There were no differences in adjusted clinical outcomes across the ratio groups. No association with clinical outcomes were found.
AHRQ-funded; HS028845.
Citation: Collins ME, Hall M, Shah SS .
Phlebotomy-free days in children hospitalized with common infections and their association with clinical outcomes.
J Hosp Med 2024 Apr; 19(4):251-58. doi: 10.1002/jhm.13282..
Keywords: Children/Adolescents, Inpatient Care, Pneumonia, Respiratory Conditions
Jopson AD, Fabius CD, Shen K
Profile of older dual-enrollees living in areas with managed long-term services and supports.
This study used the 2015 round of the National Health and Aging Trends Study (NHATS) to develop a profile of Medicare beneficiaries aged 65 years or older who are dual-enrollees with Medicaid and receive managed long-term services and supports (MLTSS). Nearly half of all state Medicaid agencies have implemented MLTSS. The sample included 275 participants who self-reported Medicaid enrollment and met the author’s definition of significant LTSS need as defined by receiving help with 2 or more self-care or mobility activities (eating, bathing, toileting, dressing, bed transfer, indoor mobility). Among approximately 1 million older dual-enrollees with significant LTSS needs, 56.2% lived in counties with MLTSS and 43.7% lived in counties with mandatory MLTSS enrollment in 2015. Those living in areas with MLTSS were much more likely to be of Hispanic or other race and ethnicity (50.5% vs 15.1%) yet less likely to live in a rural location (8.7% vs 31.4%) or in a residential care facility or nursing home (18.4% vs 34.7%). The majority (78.5%) received assistance from 2 or more aides and received more than 70 hours of care per week.
AHRQ-funded; HS000029.
Citation: Jopson AD, Fabius CD, Shen K .
Profile of older dual-enrollees living in areas with managed long-term services and supports.
J Am Med Dir Assoc 2024 Apr; 25(4):722-28. doi: 10.1016/j.jamda.2023.11.004..
Keywords: Elderly, Long-Term Care, Nursing Homes, Medicare, Medicaid
Savitz ST, Falk K, Stearns SC
Race-ethnicity and sex differences in 1-year survival following percutaneous coronary intervention among Medicare fee-for-service beneficiaries.
The objectives of this study were to evaluate differences in 1-year survival after percutaneous coronary intervention (PCI) by sex and race-ethnicity, and to explore the role of socioeconomic characteristics (SEC) to observed differences. A 20% sample of Medicare claims data for beneficiaries aged 65 and over was used to identify fee-for-service patients who received PCI from 2007-2015. Results indicated that women were more likely to experience PCI in the setting of acute myocardial infarction and had less transition to outpatient care during the period, while black patients experienced higher 1-year mortality following PCI; the authors concluded that the latter was explained by differences in baseline comorbidities, county medical resources, and state of residence.
AHRQ-funded; HS000032.
Citation: Savitz ST, Falk K, Stearns SC .
Race-ethnicity and sex differences in 1-year survival following percutaneous coronary intervention among Medicare fee-for-service beneficiaries.
J Eval Clin Pract 2024 Apr; 30(3):406-17. doi: 10.1111/jep.13954..
Keywords: Racial and Ethnic Minorities, Cardiovascular Conditions, Heart Disease and Health, Surgery, Outcomes, Social Determinants of Health
Dualeh SHA, Powell CA, Kunnath N
Rate of emergency lower extremity amputations in the United States among Medicare beneficiaries.
This study’s objective was to determine the rate of emergency versus elective lower extremity amputations in the US. The study evaluated Medicare beneficiaries who underwent lower extremity amputation between 2015 and 2020. The authors determined the rate for each zip code and placed into rank order from lowest to highest rate. They merged each beneficiary's place of residence and location of care with the American Hospital Association Annual Survey using Google Maps Application Programming Interface to determine the travel distance for patients to undergo their procedure. Of 233,084 patients, 66.3% were men, 69.8% were White. The average age at amputation was 74 years. There was wide variation in rates of emergency lower extremity amputation, with the quintile of zip codes demonstrating an emergency amputation rate of 3.7%, whereas the highest quintile demonstrating 90%. The median travel distance in the lowest emergency surgery rate quintile was 34.6 miles compared with 10.5 miles in the highest quintile of emergency surgery, suggesting variable access to essential vascular care.
AHRQ-funded; HS028606.
Citation: Dualeh SHA, Powell CA, Kunnath N .
Rate of emergency lower extremity amputations in the United States among Medicare beneficiaries.
Ann Surg 2024 Apr; 279(4):714-19. doi: 10.1097/sla.0000000000006105..
Keywords: Medicare, Surgery
Kim B, Thorpe LE, Spoer BR
State-level firearm laws and firearm homicide in US cities: heterogenous associations by city characteristics.
This study examined the associations of distinct state firearm law categories on homicide rates on various cities within the same state using identical methods. The authors examined associations of 5 categories of state firearm laws-pertaining to buyers, dealers, domestic violence, gun type/trafficking, and possession-with city-level firearm homicide, and then tested differential associations by city characteristics. They examined city-level panel data on firearm homicide cases of 78 major cities from 2010 to 2020 using the Centers for Disease Control and Prevention's National Vital Statistics System. They modeled log-transformed firearm homicide rates as a function of firearm law scores, city, state, and year fixed effects, along with time-varying city-level confounders. They considered effect measure modification by poverty, unemployment, vacant housing, and income inequality. A one z-score increase in state gun type/trafficking, possession, and dealer law scores was associated with 25%, 19%, and 17% lower firearm homicide rates, respectively. Cities with high unemployment and high housing vacancy rates had less protective associations, but more pronounced in cities with high income inequality. Large US cities had lower firearm homicide rates associated with state-level gun type/trafficking, possession, and dealer laws, but not with buyers and domestic violence laws.
AHRQ-funded; HS026120.
Citation: Kim B, Thorpe LE, Spoer BR .
State-level firearm laws and firearm homicide in US cities: heterogenous associations by city characteristics.
J Urban Health 2024 Apr; 101(2):280-88. doi: 10.1007/s11524-024-00851-1..
Keywords: Policy
Apathy NC, Zabala G, Gomes K
Telemedicine and in-person visit modality mix and electronic health record use in primary care.
This cross-sectional study examined the relationship between daily telemedicine visit share and electronic health record (EHR) usage among primary care physicians (PCPs). The analysis of 67,894 PCP-day observations revealed that days with a mix of telemedicine and in-person visits were associated with a 5.6% to 6.2% increase in EHR-based work, primarily in documentation and medical record review. However, fully telemedicine days did not show a significant association with increased EHR use. This discrepancy with previous findings is attributed to the smaller sample size of fully telemedicine days and higher average visit volume in this study. The increased EHR time on mixed-modality days may be due to multitasking during telemedicine visits. Future research should explore the potential burden of this additional EHR work on PCPs.
AHRQ-funded.
Citation: Apathy NC, Zabala G, Gomes K .
Telemedicine and in-person visit modality mix and electronic health record use in primary care.
JAMA Netw Open 2024 Apr; 7(4):e248060. doi: 10.1001/jamanetworkopen.2024.8060..
Keywords: Telehealth, Electronic Health Records (EHRs), Health Information Technology (HIT), Primary Care
Fowler ME, Harmon C, Sharafeldin N
The association between food access and frailty among older adults with gastrointestinal malignancies-the CARE Registry.
This study examined the association between food access and frailty among older adults with gastrointestinal malignancies. Eligible participants in the study included 880 adults aged 60 years and older who were recently diagnosed with GI cancers and were undergoing self-reported geriatric assessment at their first prechemotherapy visit to the University of Alabama at Birmingham oncology clinic. The authors measured food access using the 2019 US Department of Agriculture Economic Research Service designation low-income, low-access (LILA), classifying census tracts based on income and/or access to food stores at various distances. Primary outcome was frailty on the CARE (Cancer and Aging Resilience Evaluation) Frailty Index, a composite of the proportion of impaired geriatric assessment measures. A higher proportion in LILA areas were non-Hispanic Black (44.1% vs. 10.8%) and had less education (high school or less: 48.1% vs. 37.9%). Adjusting for age, race and ethnicity, sex, cancer type and stage, and education, a LILA designation was associated with 58% greater odds of worsening frailty status.
AHRQ-funded; HS013852.
Citation: Fowler ME, Harmon C, Sharafeldin N .
The association between food access and frailty among older adults with gastrointestinal malignancies-the CARE Registry.
Cancer 2024 Apr 1; 130(7):1083-91. doi: 10.1002/cncr.35144..
Keywords: Elderly, Digestive Disease and Health, Nutrition
Meille G, Koch T, Wendling B
AHRQ Author: Meille G, Zuvekas S
The consequences of firm scope and scale on patient access to healthcare.
The objective of this study was to quantify changes in the market structure of primary care physicians and to examine its relationship with access to care. Researchers created measures of market structure from a 5% sample of Medicare fee-for-service claims and examined access to care using MEPS data. The findings showed that respondents in highly concentrated ZIP codes were less likely to report having access to immediate care than respondents in unconcentrated ZIP codes; the association was largest among Medicaid beneficiaries. No association between HHI and indicators for having a usual source of care and annual checkups were found. Multispecialty market share was negatively associated with checkups, but not other measures of access.
AHRQ-authored.
Citation: Meille G, Koch T, Wendling B .
The consequences of firm scope and scale on patient access to healthcare.
Health Serv Res 2024 Apr; 59(2):e14228. doi: 10.1111/1475-6773.14228..
Keywords: Medical Expenditure Panel Survey (MEPS), Access to Care, Healthcare Delivery, Medicare
Siddique SM, Tipton K, Leas B
The impact of health care algorithms on racial and ethnic disparities : a systematic review.
The purpose of this systematic review was to examine evidence on the effect of health care algorithms and associated mitigation strategies on racial and ethnic disparities. The authors concluded that algorithms can mitigate, perpetuate, and exacerbate racial and ethnic disparities, but the evidence is heterogeneous. They noted that results are mostly based on modeling studies and may be highly context specific.
AHRQ-funded; 75Q80120D00002.
Citation: Siddique SM, Tipton K, Leas B .
The impact of health care algorithms on racial and ethnic disparities : a systematic review.
Ann Intern Med 2024 Apr; 177(4):484-96. doi: 10.7326/m23-2960..
Keywords: Disparities, Racial and Ethnic Minorities
Bayramzadeh S, Ahmadpour S
The impact of sensory stimuli on healthcare workers and outcomes in trauma rooms: a focus group study.
This study examined issues related to noise, lighting, and temperature in trauma rooms that impact patient care and staff performance. The authors recruited 65 trauma team members (e.g., surgeons, physicians, nurses) from six Level I trauma centers in the United States to participate in 20 focus groups. Focus groups were semi-structured and 1 hour long. The trauma team staff covered issues related to communications and disruption from noise sources (e.g., equipment, conversations). Having control over lighting and temperature makes a difference for both staff and patients in terms of comfort and reducing sensory overload for the staff.
AHRQ-funded; HS027261.
Citation: Bayramzadeh S, Ahmadpour S .
The impact of sensory stimuli on healthcare workers and outcomes in trauma rooms: a focus group study.
HERD 2024 Apr; 17(2):115-28. doi: 10.1177/19375867231215080..
Keywords: Provider: Health Personnel, Critical Care
Suess M, Chrenka EA, Kharbanda EO
The impact of stimulant medications on blood pressure and body mass index in children with attention deficit hyperactivity disorder.
The objective of this observational, retrospective matched cohort study was to describe changes in blood pressure (BP) and body mass index (BMI) associated with stimulant medication fills in children. Subjects were children aged 6 to just under 18 who were initiating stimulant medication, matched 1:3 by age, race, ethnicity, and sex to children with no stimulant use during the same period. Children with stimulant prescription fills and matched controls did not differ by baseline systolic BP or BMI. The results indicated that stimulant prescription fills were associated with marked decreases in BMI, but no significant changes in BP over time.
AHRQ-funded; HS027402
Citation: Suess M, Chrenka EA, Kharbanda EO .
The impact of stimulant medications on blood pressure and body mass index in children with attention deficit hyperactivity disorder.
Acad Pediatr 2024 Apr; 24(3):424-32. doi: 10.1016/j.acap.2023.08.018..
Keywords: Medication, Blood Pressure, Children/Adolescents, Behavioral Health
Muir KJ, Porat-Dahlerbruch J, Nikpour J
Top factors in nurses ending health care employment between 2018 and 2021.
The objective of this cross-sectional study was to examine top contributing factors to nurses ending health care employment between 2018-2021 in New York and Illinois. Researchers analyzed survey data (RN4CAST-NY/IL) from registered nurses; differences in contributing factors are described by nurse age, employment status, prior setting of employment, and through exemplar nurse quotes. The results showed that although planned retirement was the leading factor, nurses also cited burnout or emotional exhaustion, insufficient staffing, or family obligations. The researchers concluded that addressing these issues is within the scope of employers and may improve nurse retention.
AHRQ-funded; HS028978.
Citation: Muir KJ, Porat-Dahlerbruch J, Nikpour J .
Top factors in nurses ending health care employment between 2018 and 2021.
JAMA Netw Open 2024 Apr; 7(4):e244121. doi: 10.1001/jamanetworkopen.2024.4121..
Keywords: Provider: Nurse, Burnout
Zaccari B, Sherman ADF, Higgins M
Trauma center trauma-sensitive yoga versus cognitive processing therapy for women veterans with PTSD who experienced military sexual trauma: a feasibility study.
The objective of this study was to evaluate feasibility of a randomized controlled trial of Trauma Center Trauma-Sensitive Yoga (TCTSY) for women veterans with posttraumatic stress disorder (PTSD) related to military sexual trauma (MST). Participants were women veterans with PTSD accessing health care in a Veterans Affairs Health Care System in the southeast US; the majority were African American. Results indicated the trial design and TCTSY implementation were feasible. A full-scale randomized controlled trial was subsequently conducted to determine efficacy of the experimental intervention.
AHRQ-funded; HS026370.
Citation: Zaccari B, Sherman ADF, Higgins M .
Trauma center trauma-sensitive yoga versus cognitive processing therapy for women veterans with PTSD who experienced military sexual trauma: a feasibility study.
J Am Psychiatr Nurses Assoc 2024 Apr; 30(2):343-54. doi: 10.1177/10783903221108765..
Keywords: Behavioral Health, Complementary and Alternative Medicine, Women
Peterson BS, Trampush J, Maglione M
Treatments for ADHD in children and adolescents: a systematic review.
The purpose of this systematic review was to present an overview of treatment options for youth attention-deficit/hyperactivity disorder (ADHD). The researchers identified controlled treatment evaluations in 12 databases published from 1980 to June 2023. In total, 312 studies were included. The researchers grouped evidence for medication, psychosocial interventions, parent support, nutrition and supplements, neurofeedback, neurostimulation, physical exercise, complementary medicine, school interventions, and provider approaches. The study found that several treatments, including medications, improved ADHD symptoms. Medications were related with adverse events but provided the greatest evidence for improving outcomes, including disruptive behaviors and broadband measures.
AHRQ-funded; 75Q80120D00009.
Citation: Peterson BS, Trampush J, Maglione M .
Treatments for ADHD in children and adolescents: a systematic review.
Pediatrics 2024 Apr; 153(4):e2024065787. doi: 10.1542/peds.2024-065787..
Keywords: Children/Adolescents, Behavioral Health, Treatments
Friend R, Hash D, Rivera-Sepulveda A
Utility of serum amylase in children with abdominal pain in the pediatric emergency department.
A retrospective analysis of pediatric emergency department (PED) visits in 2019 evaluated the diagnostic utility of amylase and lipase tests in children presenting with abdominal pain. Researchers found that while both tests were frequently ordered, abnormal levels were relatively uncommon (4.6% for amylase, 5.6% for lipase). Amylase demonstrated higher sensitivity (30%) but lower specificity (92%) compared to lipase (7.5% sensitivity, 94.5% specificity). Elevating the threshold to three times the normal level improved specificity for both tests, but at the cost of reduced sensitivity. Notably, combining amylase and lipase testing did not significantly improve diagnostic yield compared to lipase alone. These findings suggest that while amylase and lipase can be useful screening tools for abdominal pain, their combined use may not offer additional clinical value.
AHRQ-funded; HS026393.
Citation: Friend R, Hash D, Rivera-Sepulveda A .
Utility of serum amylase in children with abdominal pain in the pediatric emergency department.
Pediatr Emerg Care 2024 Apr; 40(4):297-301. doi: 10.1097/pec.0000000000003032..
Keywords: Children/Adolescents, Emergency Department
Montgomery KB, Mellinger JD, Jones A
Validity of entrustable professional activities in a national sample of general surgery residency programs.
The purpose of this study was to evaluate the validity of general surgery entrustable professional activities (EPAs) when compared with Accreditation Council for Graduate Medical Education core competency Milestones. De-identified EPA Pilot Study data for five common general surgical conditions were analyzed. The results showed a moderate-to-strong positive correlation between EPAs and patient care, medical knowledge, and communication Milestones. The authors concluded that these findings support the validity of EPAs in general surgery and indicate that EPA assessments can be used to inform Milestone ratings by clinical competency committees.
AHRQ-funded; HS013852.
Citation: Montgomery KB, Mellinger JD, Jones A .
Validity of entrustable professional activities in a national sample of general surgery residency programs.
J Am Coll Surg 2024 Apr; 238(4):376-84. doi: 10.1097/xcs.0000000000000967..
Keywords: Surgery, Education: Continuing Medical Education
Beck AF, Seid M, McDowell KM
Building a regional pediatric asthma learning health system in support of optimal, equitable outcomes.
In response to Cincinnati's high pediatric asthma hospitalization rates, particularly among Black youth, a regional Asthma Learning Health System (ALHS) was established to coordinate improvement efforts. The ALHS used electronic health records and community engagement to understand the local asthma landscape and inform shared aims, measures, and interventions. Key findings revealed significant racial disparities in hospitalization rates and identified numerous disconnected asthma-related activities in the region. Qualitative insights emphasized the need for cross-sector collaboration, evidence-based care, healthy environments, and accountability. The ALHS has already initiated interventions such as population-level pattern recognition, multidisciplinary action huddles, and enhanced social needs screening, with the overarching goal of equitably reducing asthma-related hospitalizations. This approach demonstrates the potential of learning health systems to address the complex challenges of asthma and improve outcomes for affected children.
AHRQ-funded; R01 HS027996.
Citation: Beck AF, Seid M, McDowell KM .
Building a regional pediatric asthma learning health system in support of optimal, equitable outcomes.
Learn Health Syst 2024 Apr; 8(2):e10403. doi: 10.1002/lrh2.10403..
Keywords: Asthma, Children/Adolescents, Learning Health Systems, Health Systems, Respiratory Conditions
Achola EM, Griffith KN, Wrenn JO
Injuries from legal interventions involving conducted energy devices.
This cross-sectional study evaluated emergency department (ED) visits for physical injuries from use of conducted energy devices (CEDs) such as TASERs by police departments. The authors evaluated sociodemographic and clinical characteristics of patients presenting with law enforcement-related CED injuries. They sampled US ED visits from the Nationwide Emergency Department Sample, which provided a 20% stratified sample of all EDs and weights to allow calculation of national representative estimates for all ED visits. They identified 1276 visits with the ICD-10 Y35.83X codes for CED injuries. Patients included 1186 males and 91 females with a mean age of 32.9 years residing in zip codes below the 50th percentile for median household income (67.5%). Most presented to teaching hospitals (70.8%) in metropolitan areas (86.1%) and were Asian or Pacific Islander (1.4%), Black (35.7%), Hispanic (17.6%), Native American (1.8%), White (39.2%), or other (4.3%) race and ethnicity. Among patients with serious injuries (70.8%), most (61.1%) were minor, 25.4% were moderate, 2.9% were severe, and 1.6% were critical injuries. The most common area of injury was extremities (36.9%), followed by chest (27.4%), head and neck (25.6%), abdomen (24.2%), and face (8.7%). Patients with lower income were more likely to receive serious, severe, or critical injuries, but these differences were not statistically significant.
AHRQ-funded; HS026395.
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Citation: Achola EM, Griffith KN, Wrenn JO .
Injuries from legal interventions involving conducted energy devices.
JAMA Intern Med 2024 Apr; 184(4):440-43. doi: 10.1001/jamainternmed.2023.8012..
Keywords: Healthcare Cost and Utilization Project (HCUP), Injuries and Wounds, Emergency Department
Meille G
AHRQ Author: Meille G
Interruptions in insurance coverage and prescription drug utilization: evidence from Kentucky.
The purpose of this study was to examine the effects of interruptions in insurance coverage on purchases of prescription drugs for young adults. Data for 2014-18 was taken from Kentucky's prescription drug monitoring program. The findings suggested that interruptions in insurance coverage decrease prescription drug utilization by young adults and that public insurance programs such as Medicaid are important for resuming treatment.
AHRQ-authored.
Citation: Meille G .
Interruptions in insurance coverage and prescription drug utilization: evidence from Kentucky.
Med Care Res Rev 2024 Apr; 81(2):133-44. doi: 10.1177/10775587231213691..
Keywords: Young Adults, Health Insurance, Medication
Chase AM, Forehand CC, Keats KR
Evaluation of critical care pharmacist evening services at an academic medical center.
This study’s purpose was to investigate the number of interventions, type of interventions, and associated cost savings with the addition of 1 board certified critical care clinical pharmacist to evening shift. Over a 12-week period, a prospective collection and characterization of 1 evening shift critical care pharmacist’s clinical interventions was conducted. Interventions were collected and categorized daily from 1 pm to 11 pm Monday through Friday. The authors collected a total of 510 interventions with an average of 9.8 interventions accepted per day. The highest proportion of interventions occurred in the medical intensive care unit, and the most common interventions included transitions of care, medication dose adjustment, and antibiotic de-escalation. They calculated an estimated cost avoidance of $66,537.80 for an average of $1279.57 saved per day. Additionally, 4.1% of interventions were considered high yield interventions upon independent review by 2 pharmacists.
AHRQ-funded; HS029009; HS028485.
Citation: Chase AM, Forehand CC, Keats KR .
Evaluation of critical care pharmacist evening services at an academic medical center.
Hosp Pharm 2024 Apr; 59(2):228-33. doi: 10.1177/00185787231207996..
Keywords: Provider: Pharmacist, Medication, Critical Care
Hasegawa S, Harris CM, Gupta V
Clinicians' interpretation of thresholds in hospital antibiograms for gram-negative rod infections: a survey and contingent valuation study of hospitalists.
The authors surveyed hospitalists at seven U.S. healthcare systems on their reported practices related to antibiograms and their hypothetical prescribing for four clinical scenarios. The responses showed that only half of the respondents used antibiograms more than monthly. There was no evidence across the four clinical scenarios that antibiogram susceptibility levels influenced antibiotic prescribing practices. The authors concluded that antibiograms may have a limited role in hospitalist care delivery for common gram-negative rod infections.
AHRQ-funded; HS027472.
Citation: Hasegawa S, Harris CM, Gupta V .
Clinicians' interpretation of thresholds in hospital antibiograms for gram-negative rod infections: a survey and contingent valuation study of hospitalists.
J Hosp Med 2024 Apr; 19(4):297-301. doi: 10.1002/jhm.13303..
Keywords: Antibiotics