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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 25 of 33 Research Studies DisplayedDecker SL, Zuvekas SH
AHRQ Author: Decker SL, Zuvekas SH
A nationally representative summary of 2020 changes in the use of health care in the United States.
The authors used Medical Expenditure Panel Survey data to summarize changes in all types of health care from 2018 to 2020. The results showed that outpatient and emergency department visits, as well as inpatient admissions each fell ~35% in April 2020; dental visits fell by over 80%, and mammograms 82%. By the end of 2020, specialist physician visits recovered, though primary care and dental visits remained 12% lower than in 2019. Psychiatric visits, however, rose slightly.
AHRQ-authored.
Citation: Decker SL, Zuvekas SH .
A nationally representative summary of 2020 changes in the use of health care in the United States.
J Ambul Care Manage 2024 Apr-Jun; 47(2):64-83. doi: 10.1097/jac.0000000000000488.
Keywords: Medical Expenditure Panel Survey (MEPS), COVID-19, Healthcare Delivery, Public Health
Eliason EL, Agostino J, Vivier P
Infant health care disruptions by race and ethnicity, income, and insurance during the COVID-19 pandemic.
This cross-sectional study examined the impact that the COVID-19 pandemic had on infant health care, and broke it down by race and ethnicity, income, and insurance type. This study used the Pregnancy Risk Assessment Monitoring System COVID-19 supplement with data from 29 jurisdictions to examine infant health care disruptions due to the pandemic: 1) well visits/checkups canceled or delayed, 2) well visits/checkups changed to virtual appointments, and 3) postponed immunizations. The authors found that among 12,053 parental respondents with infants born from April to December 2020, 7.25% reported cancelations or delays in infant well visits/checkups, 5.49% reported changes to virtual infant care appointments, and 5.33% reported postponing immunizations, with significant differences by race and ethnicity, income, and insurance type. They found higher odds of canceling/delaying visits and postponing immunizations among non-Hispanic Black infants and infants whose parents were uninsured or had Medicaid-paid deliveries. The odds of switching to virtual appointments was also significantly higher among Hispanic infants and infants whose parents had Medicaid-paid deliveries.
AHRQ-funded; HS000011.
Citation: Eliason EL, Agostino J, Vivier P .
Infant health care disruptions by race and ethnicity, income, and insurance during the COVID-19 pandemic.
Acad Pediatr 2024 Jan-Feb; 24(1):105-10. doi: 10.1016/j.acap.2023.07.005..
Keywords: Newborns/Infants, Racial and Ethnic Minorities, COVID-19, Access to Care, Uninsured, Health Insurance, Healthcare Delivery
Hsueh L, Huang J, Millman AK
Cross-sectional association of patient language and patient-provider language concordance with video telemedicine use among patients with limited English proficiency.
The surge in telemedicine use during the COVID-19 pandemic underscores the need to address gaps in patient care, particularly for individuals with limited English proficiency. The purpose of this study was to investigate the relationship between patient language, patient-provider language alignment, and the type of telemedicine visit (video or phone consultation). The researchers conducted a cross-sectional analysis using automated data from primary care telemedicine appointments scheduled between March 16, 2020, and October 31, 2020 within a comprehensive healthcare delivery system in Northern California. A total of 22,427 completed primary care telemedicine visits booked by 13,764 patients with limited English proficiency through the patient portal. The study examined the cross-sectional link between electronic health record-documented patient language (with Spanish as the reference) and patient-provider language concordance, considering patient demographics, technology access, and technology familiarity. RESULTS: The study found that among all scheduled appointments, 34.5% (n=7747) were video consultations. The three most common patient languages were Spanish (42.4%), Cantonese (16.9%), and Mandarin (10.3%). After adjusting for demographic and technology factors, video visit usage was higher for patients speaking Cantonese, Mandarin, or Vietnamese, compared to Spanish-speaking patients, but lower for those who spoke Punjabi. Language concordance was linked to decreased video visit utilization and influenced the relationship between speaking Spanish, Cantonese, and Korean with video visit usage. Furthermore, for all language groups, patients with prior video visit experience were more likely to use video visits again.
AHRQ-funded; HS025189
Citation: Hsueh L, Huang J, Millman AK .
Cross-sectional association of patient language and patient-provider language concordance with video telemedicine use among patients with limited English proficiency.
J Gen Intern Med 2023 Feb;38(3):633-40. doi: 10.1007/s11606-022-07887-6.
Keywords: Telehealth, Health Information Technology (HIT), Cultural Competence, Clinician-Patient Communication, Communication, Healthcare Delivery, COVID-19
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.
AHRQ-authored.
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
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%).
AHRQ-funded; HS027632.
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.
AHRQ-funded; HS027632..
AHRQ-funded; HS027632..
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.
AHRQ-funded; HS028038.
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
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
Fraze TK, Beidler LB, De Marchis EH
"Beyond just a supplement": administrators' visions for the future of virtual primary care services.
The purpose of this study was to examine what health care organization administrators think about the future of virtual primary care services post-pandemic. In March-April 2021, the administrators of 17 health care organizations participated in semistructured qualitative phone interviews. The researchers explored how the administrators thought their organizations would offer virtual services after the pandemic. The study found that all the participants anticipated that their organization’s virtual primary care services would exist after the pandemic, with the main goals of 1) optimizing medical services; 2) enhancing the patient experience; and 3) increasing loyalty among patients, and the primary motivation being to remain competitive and financial solvency. The researchers concluded that administrators of health care organizations are examining how virtual services can continue after the pandemic, and what roles they will play in the delivery of services.
AHRQ-funded; HS024075.
Citation: Fraze TK, Beidler LB, De Marchis EH .
"Beyond just a supplement": administrators' visions for the future of virtual primary care services.
J Am Board Fam Med 2022 May-Jun;35(3):527-36. doi: 10.3122/jabfm.2022.03.210479..
Keywords: Primary Care, Telehealth, Health Information Technology (HIT), Healthcare Delivery, COVID-19
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.
AHRQ-funded; HS025430.
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
Bergman ZR, Usher M, Olson A
Comparison of outcomes and process of care for patients treated at hospitals dedicated for COVID-19 care vs other hospitals.
The purpose of this study was to analyze the mortality rate and complications associated with treatment at the COVID-19-dedicated hospitals. Findings showed that, in this cohort study, COVID-19-dedicated hospitals in Minnesota had multiple benefits, including providing high-volume repetitive treatment and isolating patients with the infection. This experience suggests improved in-hospital mortality for patients treated at dedicated hospitals.
AHRQ-funded; HS026732; HS026379.
Citation: Bergman ZR, Usher M, Olson A .
Comparison of outcomes and process of care for patients treated at hospitals dedicated for COVID-19 care vs other hospitals.
JAMA Netw Open 2022 Mar;5(3):e220873. doi: 10.1001/jamanetworkopen.2022.0873..
Keywords: COVID-19, Patient-Centered Outcomes Research, Evidence-Based Practice, Outcomes, Healthcare Delivery, Hospitals
Brajcich BC, Benson AB, Gantt G
Management of colorectal cancer during the COVID-19 pandemic: recommendations from a statewide multidisciplinary cancer collaborative.
J Surg Oncol 2022 Mar;125(4):560-63. doi: 10.1002/jso.26758.
AHRQ-funded; HS026385.
Citation: Brajcich BC, Benson AB, Gantt G .
Management of colorectal cancer during the COVID-19 pandemic: recommendations from a statewide multidisciplinary cancer collaborative.
J Surg Oncol 2022 Mar;125(4):560-63. doi: 10.1002/jso.26758..
Keywords: COVID-19, Cancer: Colorectal Cancer, Cancer, Guidelines, Evidence-Based Practice, Healthcare Delivery
Hays RD, Skootsky SA
Patient experience with in-person and telehealth visits before and during the COVID-19 pandemic at a large integrated health system in the United States.
Researchers sought to compare patient experience by visit type and before and during the pandemic. Using CAHPS® data, they found that patient experience with telehealth visits was as positive as or more positive than that with traditional office-based visits. Doctor communication on telehealth visits was viewed as slightly more positive than that of in-office or telephone visits. Telehealth visits were also slightly more positive than in-office visits for care coordination, overall rating of the doctor, and willingness to recommend to family and friends. Office staff were viewed less positively on the telephone than telehealth or in-office visits. Further, patient experience was similar before and during the COVID-19 pandemic.
AHRQ-funded; HS025920.
Citation: Hays RD, Skootsky SA .
Patient experience with in-person and telehealth visits before and during the COVID-19 pandemic at a large integrated health system in the United States.
J Gen Intern Med 2022 Mar;37(4):847-52. doi: 10.1007/s11606-021-07196-4..
Keywords: COVID-19, Telehealth, Health Information Technology (HIT), Patient Experience, Healthcare Delivery
Rikin S, Perez HR, Zhang C
Changes in outpatient opioid prescribing during the COVID-19 pandemic: an interrupted time series analysis.
Changes in health care delivery during the COVID-19 pandemic may have impacted opioid prescribing. This study evaluated the impact of restrictions on in-person care on opioid prescribing in the outpatient setting. The hypothesis was that after restrictions to in-person care were implemented, there would be a reduction in the number of chronic and non-chronic opioid prescriptions.
AHRQ-funded; HS026396.
Citation: Rikin S, Perez HR, Zhang C .
Changes in outpatient opioid prescribing during the COVID-19 pandemic: an interrupted time series analysis.
J Prim Care Community Health 2022 Jan-Dec;13:21501319221076926. doi: 10.1177/21501319221076926..
Keywords: COVID-19, Opioids, Medication, Practice Patterns, Healthcare Delivery
Lee DJ, Shelton JB, Brendel P
Impact of the COVID-19 pandemic on urological care delivery in the United States.
This study examined changes in urological care delivery in the US due to the COVID-19 pandemic. Real-world data was analyzed from the American Urological Association Quality (AQUA) Registry from 157 outpatient urological practices and 3,165 providers across 58 states and territories, including over 3.2 million unique patients, over 12 million outpatient visits and over 2 million procedures. Primary outcome measured was the number of outpatient visits and procedures performed from January 2019 to February 2021. The largest decline (>50%) was from March to April 2020 across all patient demographic groups and states. Nonurgent outpatient visits decreased more across various nonurgent procedures (49-59%) than for potentially urgent diagnoses (38-52%). Medicare-insured patients had the steepest declines (55%), while those on Medicaid and government insurance had the lowest percentage of care recovery to baseline. African American patients also had slower recoveries back to baseline.
AHRQ-funded; HS026372.
Citation: Lee DJ, Shelton JB, Brendel P .
Impact of the COVID-19 pandemic on urological care delivery in the United States.
J Urol 2021 Dec;206(6):1469-79. doi: 10.1097/ju.0000000000002145..
Keywords: COVID-19, Healthcare Delivery
Vranas KC, Golden SE, Mathews KS
The influence of the COVID-19 pandemic on ICU organization, care processes, and frontline clinician experiences: a qualitative study.
The COVID-19 pandemic resulted in unprecedented adjustments to intensive care unit (ICU) organization and care processes globally. The investigators examined if hospital emergency responses to the COVID-19 pandemic differed depending on hospital setting and explored which strategies worked well to mitigate strain as perceived by intensivists. The investigators concluded that their study demonstrated the importance of trust and transparency between frontline staff and hospital leadership as key components of effective emergency responses during public health crises.
AHRQ-funded; HS028038.
Citation: Vranas KC, Golden SE, Mathews KS .
The influence of the COVID-19 pandemic on ICU organization, care processes, and frontline clinician experiences: a qualitative study.
Chest 2021 Nov;160(5):1714-28. doi: 10.1016/j.chest.2021.05.041..
Keywords: COVID-19, Intensive Care Unit (ICU), Critical Care, Healthcare Delivery, Workforce, Public Health
Zachrison KS, Yan Z, Schwamm LH
Changes in virtual and in-person health care utilization in a large health system during the COVID-19 pandemic.
This cross-sectional study evaluates how the growth of virtual care has impacted health care utilization in an integrated delivery network.
AHRQ-funded; HS024561.
Citation: Zachrison KS, Yan Z, Schwamm LH .
Changes in virtual and in-person health care utilization in a large health system during the COVID-19 pandemic.
JAMA Netw Open 2021 Oct;4(10):e2129973. doi: 10.1001/jamanetworkopen.2021.29973.
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Keywords: COVID-19, Telehealth, Health Information Technology (HIT), Healthcare Delivery
Portney DS, Zhu Z, Chen EM
COVID-19 and use of teleophthalmology (CUT Group): trends and diagnoses.
The coronavirus disease 2019 (COVID-19) pandemic altered how clinicians care for patients. Ophthalmologists saw an estimated 81% drop in volume, the most of any specialty during the initial pandemic and public health restrictions. This study demonstrates the characteristics of telehealth use in ophthalmology on a large scale with primary data before and during the COVID-19 pandemic.
AHRQ-funded; HS027632.
Citation: Portney DS, Zhu Z, Chen EM .
COVID-19 and use of teleophthalmology (CUT Group): trends and diagnoses.
Ophthalmology 2021 Oct;128(10):1483-85. doi: 10.1016/j.ophtha.2021.02.010..
Keywords: COVID-19, Telehealth, Health Information Technology (HIT), Healthcare Delivery
Benneyan JC, White T, Nehls N
Systems analysis of a dedicated ambulatory respiratory unit for seeing and ensuring follow-up of patients with COVID-19 symptoms.
This paper is a systems analysis of a dedicated ambulatory respiratory unit for patients with COVID-19 symptoms. Workflow redesigns were necessitated by COVID and included new ambulatory workflows to handle surge volumes, protect patients and staff, and ensure timely reliable care. The workflow innovations observed can possibly be used to benefit routine care. Observations found that more than 85% of follow-ups were completed within 24 hours, and no staff or patient infections were associated with unit operations. Identified issues included role confusion, staffing and gatekeeping bottlenecks, and patient reluctance to visit in person or discuss concerns on the phone.
AHRQ-funded; HS027282.
Citation: Benneyan JC, White T, Nehls N .
Systems analysis of a dedicated ambulatory respiratory unit for seeing and ensuring follow-up of patients with COVID-19 symptoms.
J Ambul Care Manage 2021 Oct-Dec;44(4):293-303. doi: 10.1097/jac.0000000000000390..
Keywords: COVID-19, Ambulatory Care and Surgery, Respiratory Conditions, Workflow, Healthcare Delivery
Anesi GL, Kerlin MP
The impact of resource limitations on care delivery and outcomes: routine variation, the coronavirus disease 2019 pandemic, and persistent shortage.
Researchers discuss the impact of resource limitations on care delivery and outcomes. They conclude that the interaction between resource limitation and care delivery and outcomes is complex and incompletely understood. Further, the COVID-19 pandemic provides a learning opportunity for strain response during both pandemic and non-pandemic times.
AHRQ-funded; HS026372.
Citation: Anesi GL, Kerlin MP .
The impact of resource limitations on care delivery and outcomes: routine variation, the coronavirus disease 2019 pandemic, and persistent shortage.
Curr Opin Crit Care 2021 Oct 1;27(5):513-19. doi: 10.1097/mcc.0000000000000859..
Keywords: COVID-19, Public Health, Healthcare Delivery, Intensive Care Unit (ICU), Outcomes
Misra-Hebert AD, Hu B, Pantalone KM
Primary care health care use for patients with type 2 diabetes during the COVID-19 pandemic.
This study sought to examine factors associated with total and virtual primary care use for patients with type 2 diabetes (T2D) during the COVID-19 pandemic. This study used electronic medical records in the Cleveland Clinic Health System comparing prepandemic use from August 2019 to March 2020 (baseline period 0) to two pandemic periods: March to June 2020 (period 1) when in-person visits were converted to virtual; and July to November 2020 when in-person visits resumed (period 2). Demographic characteristics were obtained including age, sex, race, insurance type, median income estimated by zip code and baseline HbA1C. The study included 76,015 patients with T2D who completed a primary care visit in baseline period 0. Cohort median age was 66.2 years, 50.7% women, 21.7% Black, 71.0% White and 7.4 Other. Insurance distribution was 43.2% private, 46.5% Medicare, and 9.5% Medicaid. Median income was estimated at $59,000 and baseline HbA1C was ≤ 7% for 59.6% of patients. There were higher odds of Black patients, those with uncontrolled T2D, and those with Medicare and Medicare using virtual visits during the 2 postpandemic periods suggesting that virtual visits may be a preference for those groups. Older and male patients had lower odds of visit completion.
AHRQ-funded; HS024128.
Citation: Misra-Hebert AD, Hu B, Pantalone KM .
Primary care health care use for patients with type 2 diabetes during the COVID-19 pandemic.
Diabetes Care 2021 Sep;44(9):e173-e74. doi: 10.2337/dc21-0853..
Keywords: COVID-19, Diabetes, Primary Care, Telehealth, Health Information Technology (HIT), Healthcare Delivery, Access to Care, Chronic Conditions
Barbash IJ, Kahn JM
Fostering hospital resilience-lessons from COVID-19.
This article describes how hospitals can foster organizational resistance using lessons from the COVID-19 pandemic. They describe what resilience would look like including: 1) resilient hospitals would respond to a surge in COVID-19 cases in ways that ensure the delivery of high-quality care for patients with the disease; 2) resilient hospitals would response to COVID-19 surges in ways that preserve standards of care for patients without COVID-19; 3) resilient hospitals would preserve access to care for the entire community of patients they serve, including continuing elective surgeries and mitigating effects of health disparities; and 4) resilient hospitals would do all of this while protecting the well-being of frontline staff. Protection of front-line staff includes ensuring adequate personal protective equipment as well as through clear communication from leaders. Factors that foster resilience are described including well-developed, scalable clinical protocols, flexible electronic health records, and a supportive, interdisciplinary working environment in which all team members feel safe to raise concerns and share new ideas. Resilience might also be fostered among hospitals through their interactions.
AHRQ-funded; HS025455.
Citation: Barbash IJ, Kahn JM .
Fostering hospital resilience-lessons from COVID-19.
JAMA 2021 Aug 24; 326(8):693-94. doi: 10.1001/jama.2021.12484..
Keywords: COVID-19, Hospitals, Healthcare Delivery, Public Health
Parmasad V, Keating JA, Carayon P
Physical distancing for care delivery in health care settings: considerations and consequences.
Physical distancing in high complexity systems such as health care is particularly challenging and may benefit from a human factors and systems engineering perspective. In this paper the investigators discussed challenges to implementing and maintaining physical distancing in health care settings and presented possible solutions from a human factors and systems engineering perspective.
AHRQ-funded; HS026226.
Citation: Parmasad V, Keating JA, Carayon P .
Physical distancing for care delivery in health care settings: considerations and consequences.
Am J Infect Control 2021 Aug;49(8):1085-88. doi: 10.1016/j.ajic.2020.12.014..
Keywords: COVID-19, Healthcare Delivery, Patient Safety
Clair K, Ijadi-Maghsoodi R, Nazinyan M
Veteran perspectives on adaptations to a VA residential rehabilitation program for substance use disorders during the novel coronavirus pandemic.
This paper looks at veterans’ perspectives on adaptations made to a VA residential rehabilitation program for substance use disorders during the novel coronavirus pandemic. Adaptations to services are described within a large residential rehabilitation program for under-resourced veterans; reports veterans’ experiences; and outlines successes and challenges encountered. Data was collected from two focus groups with nine veterans in the program. The groups highlighted experiences of inconsistent communication about residential policies, interruptions to medical and addiction services, and feelings of confinement and social isolation.
AHRQ-funded; HS026407.
Citation: Clair K, Ijadi-Maghsoodi R, Nazinyan M .
Veteran perspectives on adaptations to a VA residential rehabilitation program for substance use disorders during the novel coronavirus pandemic.
Community Ment Health J 2021 Jul;57(5):801-07. doi: 10.1007/s10597-021-00810-z..
Keywords: Substance Abuse, Rehabilitation, COVID-19, Healthcare Delivery, Access to Care, Patient Experience
Peahl AF, Powell A, Berlin H
Patient and provider perspectives of a new prenatal care model introduced in response to the coronavirus disease 2019 pandemic.
The authors evaluated institutional-level adoption and patient and provider experiences with a coronavirus disease 2019 prenatal care model. They found that reduced visit schedules and virtual visits were rapidly integrated into real-world care, with positive experiences for many patients and providers. They recommended future research to understand the health outcomes and care experience associated with alternative approaches to prenatal care delivery across more diverse patient populations outside of the coronavirus disease 2019 pandemic to inform broader health policy decisions.
AHRQ-funded; HS025465.
Citation: Peahl AF, Powell A, Berlin H .
Patient and provider perspectives of a new prenatal care model introduced in response to the coronavirus disease 2019 pandemic.
Am J Obstet Gynecol 2021 Apr;224(4):384.e1-84.e11. doi: 10.1016/j.ajog.2020.10.008..
Keywords: Maternal Care, Pregnancy, Patient-Centered Healthcare, Telehealth, Health Information Technology (HIT), Healthcare Delivery, COVID-19
Etherton MR, Zachrison KS, Yan Z
Regional changes in patterns of stroke presentation during the COVID-19 pandemic.
The authors sought to determine the effect of the coronavirus pandemic on patterns of stroke patient presentation and quality of care. They analyzed data from 25 New England hospitals: one urban, academic, comprehensive stroke center and telestroke hub, and 24 spoke hospitals in the same telestroke network. They included all telestroke consultations from the 24 spokes, and stroke admissions to the comprehensive stroke center hub from November 2019 through April 2020. They compared rates of presentation, timeliness presentation, and quality of care pre- versus post-March 2020. They also examined trends in patient demographics, stroke severity, timeliness, diagnosis including large vessel occlusion, alteplase use, and endovascular thrombectomy among eligible subjects. Among 1248 patient presentations, telestroke consultations and ischemic stroke patient admissions decreased through the hub and spoke network. Age and stroke severity were unchanged during the study period. However, rates of adherence for the quality measures dysphagia screening, early antithrombotic initiation, and early venous thromboembolism prophylaxis were reduced during the pandemic.
AHRQ-funded; HS024561.
Citation: Etherton MR, Zachrison KS, Yan Z .
Regional changes in patterns of stroke presentation during the COVID-19 pandemic.
Stroke 2021 Apr;52(4):1398-406. doi: 10.1161/strokeaha.120.031300..
Keywords: Stroke, Cardiovascular Conditions, COVID-19, Telehealth, Health Information Technology (HIT), Healthcare Delivery