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Topics
- (-) Access to Care (9)
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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 9 of 9 Research Studies DisplayedAdams DR
Availability and accessibility of mental health services for youth: a descriptive survey of safety-net health centers during the COVID-19 pandemic.
The goal of this study was to assess the availability of outpatient mental health services for children and adolescents at safety-net health centers in a large metropolitan county. A comprehensive sample of Community Mental Health Centers (CMHCs) and Federally Qualified Health Centers (FQHCs) received a 5-minute survey approximately one year after the beginning of the COVID-19 pandemic. The response indicated that 10% of health centers had closed and 20% reported that they were not offering outpatient mental health services. Reported wait times were longer at CMHCs than FQHCs. The author concluded that these findings suggested that online directories such as the SAMHSA Treatment Locator are often inaccurate or out-of-date.
AHRQ-funded; HS000084.
Citation: Adams DR .
Availability and accessibility of mental health services for youth: a descriptive survey of safety-net health centers during the COVID-19 pandemic.
Community Ment Health J 2024 Jan; 60(1):88-97. doi: 10.1007/s10597-023-01127-9..
Keywords: Children/Adolescents, Behavioral Health, Access to Care, COVID-19, Public Health
Auty SG, Aswani MS, Wahbi RN
Changes in health care access by race, income, and Medicaid expansion during the COVID-19 pandemic.
This study examined changes in access to care during the COVID-19 pandemic, stratified by race/ethnicity, household income, and state Medicaid expansion status. Data were extracted for all adults (N = 1,731,699) aged 18-64 surveyed in the 2015-2020 Behavioral Risk Factor Surveillance System from all 50 states and the District of Columbia. The pandemic was associated with a 1.2 percentage point decline in uninsurance for Medicaid expansion states, with reductions concentrated among respondents who were Black, multiracial, or low income. Rates of uninsurance were generally stable in nonexpansion states. Rates of avoided care because of cost fell by 3.5 percentage points in Medicaid expansion states, and by 3.6 percentage points in nonexpansion states. These declines were also concentrated among minority or low-income respondents.
AHRQ-funded; HS026395.
Citation: Auty SG, Aswani MS, Wahbi RN .
Changes in health care access by race, income, and Medicaid expansion during the COVID-19 pandemic.
Med Care 2023 Jan;61(1):45-49. doi: 10.1097/mlr.0000000000001788..
Keywords: COVID-19, Access to Care, Medicaid, Public Health, Racial and Ethnic Minorities, Low-Income
Cutler GJ, Bergmann KR, Doupnik SK
Pediatric mental health emergency department visits and access to Inpatient care: a crisis worsened by the COVID-19 pandemic.
The purpose of this study was to explore the author’s previous research findings on trends in pediatric emergency department (ED) visits for mental health (MH) vs non-mental health in light of more recent related data corresponding with the COVID-19 pandemic. The study found that recent research supports the dramatic increase in pediatric MH ED visits found in the author’s previous research and provides additional evidence that the increase has been driven by specific MH diagnoses. The researchers conclude that depressive disorders, self-harm behavior, and non-alcohol substance use disorders should be prioritized for the development of ED- and hospital-based strategies, and that EDs, hospitals, health systems, and the government urgently need to increase capacity for MH services and identify innovative solutions to improve access to high quality MH care for children.
AHRQ-funded; HS026385.
Citation: Cutler GJ, Bergmann KR, Doupnik SK .
Pediatric mental health emergency department visits and access to Inpatient care: a crisis worsened by the COVID-19 pandemic.
Acad Pediatr 2022 Aug;22(6):889-91. doi: 10.1016/j.acap.2022.03.015..
Keywords: Children/Adolescents, COVID-19, Behavioral Health, Emergency Department, Access to Care, Public Health, Inpatient Care
Fleming MD, Evans JL, Graham-Squire D
Association of shelter-in-place hotels with health services use among people experiencing homelessness during the COVID-19 pandemic.
During the COVID-19 pandemic, some jurisdictions utilized shelter-in-place (SIP) hotels to provide emergency shelter and support services to people experiencing homelessness (PEH) to reduce the risk of COVID-19 infection. The purpose of this study was to evaluate the association of SIP hotel placements with prior high acute health service use and compare health services use between PEH with prior high service use who did and did not receive a SIP hotel placement. The researchers assessed 25 SIP hotels in San Francisco, California from April 2020 to April 2021 and analyzed data from February 2021 to May 2022. Study participants included PEH who were among the top 10% high users of acute medical, mental health, and substance use services and who had 3 or more emergency department (ED) visits in the 9 months before the implementation of the SIP hotel program. The study reported that the mean number of ED visits decreased significantly in the high-user SIP group compared with high-user controls. The mean number of hospitalizations decreased significantly from 0.41 to 0.14 for SIP guests vs 0.27 to 0.22 for controls. Inpatient hospital days decreased significantly from a mean of 4.00 to 0.81 for SIP guests vs 2.27 to 1.85 for controls as did psychiatric emergency visits, from a mean of 0.03 to 0.01 visits for SIP guests vs no change in the control group. The researchers concluded that placement of PEH in SIP hotels was correlated with significantly reduced acute care use when compared with high acute care users with no SIP placement.
AHRQ-funded; HS027648.
Citation: Fleming MD, Evans JL, Graham-Squire D .
Association of shelter-in-place hotels with health services use among people experiencing homelessness during the COVID-19 pandemic.
JAMA Netw Open 2022 Jul;5(7):e2223891. doi: 10.1001/jamanetworkopen.2022.23891..
Keywords: COVID-19, Access to Care, Healthcare Utilization, Public Health
Johnson CL, Schwartz H, Greenberg A
Patient perceptions on barriers and facilitators to accessing low-acuity surgery during COVID-19 pandemic.
The onset of the COVID-19 pandemic led to the postponement of low-acuity surgical procedures in an effort to conserve resources and ensure patient safety. This study aimed to characterize patient-reported concerns about undergoing surgical procedures during the pandemic. The investigators concluded that eliciting patients' perspectives, adapting processes to address potential barriers, and effectively educating patients about institutional measures to minimize in-hospital transmission of COVID-19 should be integrated into surgical care.
AHRQ-funded; HS024532.
Citation: Johnson CL, Schwartz H, Greenberg A .
Patient perceptions on barriers and facilitators to accessing low-acuity surgery during COVID-19 pandemic.
J Surg Res 2021 Aug;264:30-36. doi: 10.1016/j.jss.2021.01.028..
Keywords: COVID-19, Surgery, Access to Care, Patient Experience, Public Health
Martin BI, Brodke DS, Wilson FA
The impact of halting elective admissions in anticipation of a demand surge due to the coronavirus pandemic (COVID-19).
This study’s objective was to estimate excess demand for hospital beds due to COVID-19 and the net financial impact of eliminating elective admissions to meet demand. An economic simulation was conducted combining epidemiological reports, the US Census, American Hospital Association Annual Survey, and the National Inpatient Sample. The base case used relied on a hospital admission rate reported by the CDC of 137.6 per 100,000, with the highest rates in people aged 65 year and older and 50-64 years. Elective admissions accounted for 20% of total hospital admissions, with an average rate of 30% unoccupied beds across hospitals. Hospitals that restricted elective care due to a COVID surge was only financial favorable if capacity was filled by a high proportion of COVID-19 cases among hospitals with low rates of elective admissions. There is a substantial financial risk to hospitals that restrict elective care.
AHRQ-funded; HS024714.
Citation: Martin BI, Brodke DS, Wilson FA .
The impact of halting elective admissions in anticipation of a demand surge due to the coronavirus pandemic (COVID-19).
Med Care 2021 Mar;59(3):213-19. doi: 10.1097/mlr.0000000000001496..
Keywords: Healthcare Cost and Utilization Project (HCUP), COVID-19, Hospitals, Healthcare Costs, Access to Care, Public Health
Anderson KE, McGinty EE, Presskreischer R
Reports of forgone medical care among US adults during the initial phase of the COVID-19 pandemic.
This survey measured the frequency of foregone medical care due to COVID-19 from March to mid-July 2020. Johns Hopkins created the COVID-19 Civic Life and Public Health Survey wave 1, with 1468 individuals completing the survey. The sample of respondents were 52% women, 63% non-Hispanic White, 12% Black, and 17% Hispanic. The mean age of respondents was 48 years. A total of 41% of respondents forwent medical care during the March to mid-July time period. Among the 1055 individuals who reported needing care, 52% reported forgoing care for any reason, 29% forwent care owing to fear of COVID-19 transmission, and 7% forwent care owing to financial concerns associated with the pandemic. Respondents lacking any health insurance were more likely to forgo care than respondents with Medicare or commercial insurance.
AHRQ-funded; HS000029.
Citation: Anderson KE, McGinty EE, Presskreischer R .
Reports of forgone medical care among US adults during the initial phase of the COVID-19 pandemic.
JAMA Netw Open 2021 Jan 4;4(1):e2034882. doi: 10.1001/jamanetworkopen.2020.34882..
Keywords: COVID-19, Access to Care, Healthcare Utilization, Public Health, Infectious Diseases
Patterson ES, Papautsky EL, Krok-Schoen JL
Scheduling delayed treatment and surgeries post-pandemic: a stakeholder analysis.
The purpose of this study was to assess diverse stakeholder perspectives regarding how to trade off risks and benefits to patients, healthcare providers, and the local community. The study found that there exists a high number of different categories of stakeholders affected by the post-pandemic decisions to reschedule delayed treatments and surgeries. The primary stakeholders for a delayed surgery are the surgeon with knowledge of the clinical benefits of undertaking an operation and the patient's willingness to tolerate uncertainty and the increased risk of infection. For decisions about capacity in the operating rooms and inpatient setting after the surgery, the primary factors are reducing staff infections, preventing patients from contracting COVID-19 during operations and during post-surgical recovery at the hospital, conserving critical resources such as Personal Protective Equipment (PPE), and addressing the quality of life needs of hospital staff, such as childcare and preventing infecting members of their household. The timing and selection of elective surgery cases has an effect on the ability of hospitals to manage finances, which impacts decisions about staff employment when resources such as rooms are not being utilized.
AHRQ-funded; HS024379.
Citation: Patterson ES, Papautsky EL, Krok-Schoen JL .
Scheduling delayed treatment and surgeries post-pandemic: a stakeholder analysis.
Proc Int Symp Hum Factors Ergon Healthc 2020 Sep;9(1):10-14. doi: 10.1177/2327857920091066..
Keywords: COVID-19, Surgery, Public Health, Access to Care
Hsuan C, Rodriguez HP
The adoption and discontinuation of clinical services by local health departments.
The researchers identified factors associated with local health department (LHD) adoption and discontinuation of clinical services. They found that most LHDs are discontinuing clinical services over time. Those that cover a wide range of core public health functions are less likely to discontinue services when residents lack care access.
AHRQ-funded; AHRQ Predoctoral Traineeship.
Citation: Hsuan C, Rodriguez HP .
The adoption and discontinuation of clinical services by local health departments.
Am J Public Health 2014 Jan;104(1):124-33. doi: 10.2105/ajph.2013.301426..
Keywords: Public Health, Access to Care, Health Services Research (HSR)