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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 12 of 12 Research Studies DisplayedMartin 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
Bartsch SM, Asti L, Stokes-Cawley OJ
The potential economic value of a Zika vaccine for a woman of childbearing age.
The authors mapped the Zika vaccine and vaccination characteristic thresholds at which vaccination becomes cost effective, highly cost effective, and cost saving. They developed a Markov model to simulate a woman of childbearing age to follow the potential risk and clinical course of a Zika infection. They found that, in some cases, the vaccine was cost effective when the risk was as low as 0.015%, the cost was as high as $7,500, the efficacy was as low as 25%, and the duration of protection was 1 year. They concluded that the thresholds at which vaccination becomes cost effective and cost saving can provide targets for Zika vaccine development and implementation.
AHRQ-funded; HS023317.
Citation: Bartsch SM, Asti L, Stokes-Cawley OJ .
The potential economic value of a Zika vaccine for a woman of childbearing age.
Am J Prev Med 2020 Mar;58(3):370-77. doi: 10.1016/j.amepre.2019.10.023..
Keywords: Vaccination, Women, Infectious Diseases, Public Health, Healthcare Costs, Prevention
Bartsch SM, Asti L, Cox SN
What is the value of different Zika vaccination strategies to prevent and mitigate Zika outbreaks?
The authors developed models of Honduras, Brazil, and Puerto Rico, simulated targeting different populations for Zika vaccination, and then introduced various Zika outbreaks. Their models showed that, when considering transmission, while vaccinating everyone naturally averted the most cases, specifically targeting women of childbearing age or young adults was the most cost-effective.
AHRQ-funded; HS023317.
Citation: Bartsch SM, Asti L, Cox SN .
What is the value of different Zika vaccination strategies to prevent and mitigate Zika outbreaks?
J Infect Dis 2019 Aug 9;220(6):920-31. doi: 10.1093/infdis/jiy688..
Keywords: Healthcare Costs, Vaccination, Public Health, Infectious Diseases
Malloy GSP, Brandeau ML, Goldhaber-Fiebert JD
Modeling the cost-effectiveness of interventions to prevent plague in Madagascar.
The authors assessed the cost-effectiveness of plague (Yersinia pestis) control interventions recommended by the World Health Organization with particular consideration to intervention coverage and timing. They calculated costs, quality-adjusted life years (QALYs), and incremental cost-effectiveness ratios from a healthcare perspective. The preferred intervention, using a cost-effectiveness threshold of $1350/QALY, was expanded access to antibiotic treatment with doxycycline with 100% coverage starting immediately after the first reported case, gaining 543 QALYs at an incremental cost of $1023/QALY gained. Sensitivity analyses support expanded access to antibiotic treatment and leave open the possibility that mass distribution of doxycycline prophylaxis or mass distribution of malathion could be cost-effective.
AHRQ-funded; HS026128.
Citation: Malloy GSP, Brandeau ML, Goldhaber-Fiebert JD .
Modeling the cost-effectiveness of interventions to prevent plague in Madagascar.
Trop Med Infect Dis 2021 Jun 11;6(2). doi: 10.3390/tropicalmed6020101..
Keywords: Infectious Diseases, Healthcare Costs, Public Health, Prevention
Yoo BK, Schaffer SJ, Humiston SG
Cost effectiveness of school-located influenza vaccination programs for elementary and secondary school children.
This paper describes a clinical trial which created a school-located influenza vaccination (SLIV) program in upstate New York. Researchers wanted to determine if this was a cost-effective alternative to vaccination in primary care practices. Two groups of students were vaccinated – one in an elementary school and the other in a secondary school. Secondary school vaccinations were more cost-effective than elementary schools with a lower median cost per vaccination. The authors concluded that it does raise vaccination rates, but it is not cost-effective due to the higher costs for consent systems and project coordination.
AHRQ-funded; HS021163.
Citation: Yoo BK, Schaffer SJ, Humiston SG .
Cost effectiveness of school-located influenza vaccination programs for elementary and secondary school children.
BMC Health Serv Res 2019 Jun 24;19(1):407. doi: 10.1186/s12913-019-4228-5..
Keywords: Children/Adolescents, Education, Healthcare Costs, Influenza, Public Health, Vaccination
Wedlock PT, Mitgang EA, Oron AP
Modeling the economic impact of different vial-opening thresholds for measles-containing vaccines.
The lack of specific policies on how many children must be present at a vaccinating location before a healthcare worker can open a measles-containing vaccine (MCV) - i.e. the vial-opening threshold - has led to inconsistent practices, which can have wide-ranging systems effects. Using HERMES-generated simulation models of the routine immunization supply chains of Benin, Mozambique and Niger, the investigators evaluated the impact of different vial-opening thresholds (none, 30% of doses must be used, 60%) and MCV presentations (10-dose, 5-dose) on each supply chain.
AHRQ-funded; HS023317.
Citation: Wedlock PT, Mitgang EA, Oron AP .
Modeling the economic impact of different vial-opening thresholds for measles-containing vaccines.
Vaccine 2019 Apr 17;37(17):2356-68. doi: 10.1016/j.vaccine.2019.03.017..
Keywords: Vaccination, Infectious Diseases, Healthcare Costs, Public Health
Bartsch SM, Taitel MS, DePasse JV
Epidemiologic and economic impact of pharmacies as vaccination locations during an influenza epidemic.
During an influenza epidemic, where early vaccination is crucial, pharmacies may be a resource to increase vaccine distribution reach and capacity. In this paper, the investigators utilized an agent-based model of the US and a clinical and economics outcomes model to simulate the impact of different influenza epidemics and the impact of utilizing pharmacies in addition to traditional (hospitals, clinic/physician offices, and urgent care centers) locations for vaccination for the year 2017.
AHRQ-funded; HS023317.
Citation: Bartsch SM, Taitel MS, DePasse JV .
Epidemiologic and economic impact of pharmacies as vaccination locations during an influenza epidemic.
Vaccine 2018 Nov 12;36(46):7054-63. doi: 10.1016/j.vaccine.2018.09.040..
Keywords: Healthcare Costs, Influenza, Provider: Pharmacist, Public Health, Vaccination
de Montigny S, Adamson BJS, Masse BR
Projected effectiveness and added value of HIV vaccination campaigns in South Africa: a modeling study.
Sci Rep 2018 Apr 17;8(1):6066. doi: 10.1038/s41598-018-24268-4.
In this paper, the authors estimated the potential epidemiological and economic impact of HIV vaccine campaigns compared to continuous vaccination, assuming that vaccine efficacy was transient and dependent on immune response. The investigators concluded that results suggested a partially effective HIV vaccine would have substantial impact on the HIV epidemic in South Africa and offer good value if priced less than $105 for a five-dose series. They suggested that vaccination campaigns every two years may offer greater value for money than continuous vaccination reaching the same coverage level.
In this paper, the authors estimated the potential epidemiological and economic impact of HIV vaccine campaigns compared to continuous vaccination, assuming that vaccine efficacy was transient and dependent on immune response. The investigators concluded that results suggested a partially effective HIV vaccine would have substantial impact on the HIV epidemic in South Africa and offer good value if priced less than $105 for a five-dose series. They suggested that vaccination campaigns every two years may offer greater value for money than continuous vaccination reaching the same coverage level.
AHRQ-funded; HS013853.
Citation: de Montigny S, Adamson BJS, Masse BR .
Projected effectiveness and added value of HIV vaccination campaigns in South Africa: a modeling study.
Sci Rep 2018 Apr 17;8(1):6066. doi: 10.1038/s41598-018-24268-4..
Keywords: Health Services Research (HSR), Healthcare Costs, Human Immunodeficiency Virus (HIV), Public Health, Vaccination
Bradley EH, Canavan M, Rogan E
Variation in health outcomes: the role of spending on social services, public health, and health care, 2000-09.
This study found that states with a higher ratio of social to health spending (calculated as the sum of social service spending and public health spending divided by the sum of Medicare spending and Medicaid spending) had significantly better subsequent health outcomes for the following seven measures: adult obesity; asthma; mentally unhealthy days; days with activity limitations; and mortality rates for lung cancer, acute myocardial infarction, and type 2 diabetes.
AHRQ-funded; HS017589.
Citation: Bradley EH, Canavan M, Rogan E .
Variation in health outcomes: the role of spending on social services, public health, and health care, 2000-09.
Health Aff 2016 May;35(5):760-8. doi: 10.1377/hlthaff.2015.0814.
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Keywords: Outcomes, Social Determinants of Health, Healthcare Costs, Health Status, Public Health
Bartsch SM, Lopman BA, Ozawa S
Global economic burden of norovirus gastroenteritis.
The researchers developed a computational simulation model to estimate the economic burden of norovirus in every country/area stratified by WHO region and globally, from the health ystem and societal perspectives. They found that globally, orovirus resulted in a total of $4.2 billion in direct health system costs and $60.3 billion in societal costs per year.
AHRQ-funded; HS023317.
Citation: Bartsch SM, Lopman BA, Ozawa S .
Global economic burden of norovirus gastroenteritis.
PLoS One 2016 Apr 26;11(4):e0151219. doi: 10.1371/journal.pone.0151219.
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Keywords: Healthcare Costs, Public Health, Policy
Bartsch SM, Gorham K, Lee BY
The cost of an Ebola case.
The researchers developed a mathematical model to estimate the cost of an Ebola virus disease (EVD) case from the provider and societal perspectives in the three most affected countries of Guinea, Liberia, and Sierra Leone. Their model estimates the total societal cost of an EVD case with full recovery ranges from $480 to $912, while that of an EVD case not surviving ranges from $5,929 to $18,929, varying by age and country.
AHRQ-funded; HS023317.
Citation: Bartsch SM, Gorham K, Lee BY .
The cost of an Ebola case.
Pathog Glob Health 2015 Feb;109(1):4-9. doi: 10.1179/2047773214y.0000000169..
Keywords: Healthcare Costs, Mortality, Public Health, Infectious Diseases
Khazeni N, Hutton DW, Collins CI
Health and economic benefits of early vaccination and nonpharmaceutical interventions for a human influenza A (H7N9) pandemic: a modeling study.
In order to determine how quickly vaccination should be completed to reduce infections, deaths, and health care costs in a severe influenza pandemic in a large metropolitan area, researchers used a dynamic transmission model. They found that vaccination in an influenza-A (H7N9) pandemic would need to be completed much faster than in the 2009 pandemic to substantially reduce morbidity, mortality, and health care costs.
AHRQ-funded; HS019816
Citation: Khazeni N, Hutton DW, Collins CI .
Health and economic benefits of early vaccination and nonpharmaceutical interventions for a human influenza A (H7N9) pandemic: a modeling study.
Ann Intern Med. 2014 May 20;160(10):684-94. doi: 10.7326/M13-2071..
Keywords: Vaccination, Influenza, Mortality, Healthcare Costs, Public Health