National Healthcare Quality and Disparities Report
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- Access to Care (3)
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- (-) Surgery (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 DisplayedShipe ME, Baechle JJ, Deppen SA
Modeling the impact of delaying surgery for early esophageal cancer in the era of COVID-19.
Surgical society guidelines have recommended changing the treatment strategy for early esophageal cancer during the novel coronavirus (COVID-19) pandemic. Delaying resection can allow for interim disease progression, but the impact of this delay on mortality is unknown. The COVID-19 infection rate at which immediate operative risk exceeds benefit is unknown. In this study, the investigators sought to model immediate versus delayed surgical resection in a T1b esophageal adenocarcinoma.
AHRQ-funded; HS026122.
Citation: Shipe ME, Baechle JJ, Deppen SA .
Modeling the impact of delaying surgery for early esophageal cancer in the era of COVID-19.
Surg Endosc 2021 Nov;35(11):6081-88. doi: 10.1007/s00464-020-08101-6..
Keywords: COVID-19, Cancer, Surgery, Decision Making, Risk
Tignanelli CJ, Bramante CT, Dutta NT
Metabolic surgery may protect against admission for COVID-19 in persons with nonalcoholic fatty liver disease.
SARS-CoV-2 (COVID-19) disease causes significant morbidity and mortality through increased inflammation and thrombosis. Nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH) are states of chronic inflammation and indicate advanced metabolic disease. The purpose of this observational study was to characterize the risk of hospitalization for COVID-19 in patients with NAFLD/NASH and evaluate the mitigating effect of various metabolic treatments.
AHRQ-funded; HS026379.
Citation: Tignanelli CJ, Bramante CT, Dutta NT .
Metabolic surgery may protect against admission for COVID-19 in persons with nonalcoholic fatty liver disease.
Surg Obes Relat Dis 2021 Oct;17(10):1780-86. doi: 10.1016/j.soard.2021.05.029..
Keywords: COVID-19, Surgery, Obesity: Weight Management, Obesity
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
Purnell TS, Simpson DC, Callender CO
Dismantling structural racism as a root cause of racial disparities in COVID-19 and transplantation.
As the United States faces unparalleled challenges due to COVID-19, racial disparities in health and healthcare have once again taken center stage. If effective interventions to address racial disparities in transplantation, including those magnified by COVID-19, are to be designed and implemented at the national level, it is first critical to understand the complex mechanisms by which structural, institutional, interpersonal, and internalized racism influence the presence of racial disparities in healthcare and transplantation. IN this article the authors discuss their viewpoint.
AHRQ-funded; HS024600.
Citation: Purnell TS, Simpson DC, Callender CO .
Dismantling structural racism as a root cause of racial disparities in COVID-19 and transplantation.
Am J Transplant 2021 Jul;21(7):2327-32. doi: 10.1111/ajt.16543..
Keywords: COVID-19, Racial and Ethnic Minorities, Disparities, Transplantation, Surgery, Access to Care
Chao GF, Li KY, Zhu Z
Use of telehealth by surgical specialties during the COVID-19 pandemic.
This study’s objective was to determine telehealth use by surgical specialty before and during the pandemic period starting in March 2020. Insurance claims from a Michigan statewide commercial payer for new patient visits with a surgeon from 1 of 9 surgical specialties during one of the following periods: prior to the COVID-19 pandemic (period 1: January 5 to March 7, 2020), early pandemic (period 2: March 8 to June 6, 2020), and late pandemic (period 3: June 7 to September 5, 2020) were analyzed. For new patient visits, 1182 surgeons (26.8%) in any patient context used telehealth. Telehealth use peaked in April 2020 and facilitated 34.6% of all new patient visits during that week. Urology was the specialty with the highest telehealth conversion rate (14.3%).
AHRQ-funded; HS027632.
Citation: Chao GF, Li KY, Zhu Z .
Use of telehealth by surgical specialties during the COVID-19 pandemic.
JAMA Surg 2021 Jul;156(7):620-26. doi: 10.1001/jamasurg.2021.0979..
Keywords: COVID-19, Telehealth, Health Information Technology (HIT), Access to Care, Practice Patterns, Surgery
Brown CS, Albright J, Henke PK
Modeling the elective vascular surgery recovery after coronavirus disease 2019: implications for moving forward.
This study looked at the impact of delays in elective vascular surgery caused by the coronavirus pandemic. Data from a 35-hospital regional vascular surgical collaborative consisting of all hospitals performing vascular surgery in the state of Michigan was used to estimate the number of delayed surgical cases for adults undergoing carotid endarterectomy, carotid stenting, endovascular and open abdominal aortic aneurysm repair, and lower extremity bypass. Median statewide monthly vascular surgical volume before the pandemic was 439 procedures, with a maximum statewide monthly case volume of 519 procedures. For the month of April 2020, elective vascular surgery procedure volume decreased by ~90%. Modelling estimated it would take approximately 8 months to catch up with the backlog. The authors suggest that if hospitals across the collaborative shared the burden of backlogged cases, the recovery should be shortened to ~3 months.
AHRQ-funded; HS000053.
Citation: Brown CS, Albright J, Henke PK .
Modeling the elective vascular surgery recovery after coronavirus disease 2019: implications for moving forward.
J Vasc Surg 2021 Jun;73(6):1876-80.e1. doi: 10.1016/j.jvs.2020.11.025..
Keywords: COVID-19, Infectious Diseases, Cardiovascular Conditions, Surgery
Byrnes ME, Brown CS, De Roo A
Elective surgical delays due to COVID-19: the patient lived experience.
This study looked at the effects of the COVID-19 pandemic on scheduling of elective cardiac and vascular surgery. The authors interviewed 47 individuals who experienced a postponement of surgery due to coronavirus. Patients described 3 key issues around their postponement: 1) surgery as part of a “return to normal”; 2) postponement took a toll on their physical health and mental wellbeing; and 3) many patients in their study said they would “rather die from a heart attack” than be exposed to the coronavirus.
AHRQ-funded; HS000053.
Citation: Byrnes ME, Brown CS, De Roo A .
Elective surgical delays due to COVID-19: the patient lived experience.
Med Care 2021 Apr;59(4):288-94. doi: 10.1097/mlr.0000000000001503..
Keywords: COVID-19, Surgery, Public Health, Patient Experience, Infectious Diseases
Shipe ME, Beeghly-Fadiel A, Deppen SA
Modeling the impact of delaying bariatric surgery due to COVID-19: a decision analysis.
In this study, the investigators developed a decision analysis model to evaluate risks and benefits of delaying scheduled bariatric surgery during the novel coronavirus disease (COVID-19) pandemic. Their base case was a 45-year-old female with diabetes and a body mass index of 45 kg/m(2). They compared immediate with delayed surgery after 6 months to allow for COVID-19 prevalence to decrease. The investigators found that immediate and delayed bariatric surgeries after 6 months resulted in similar 20-year overall survival.
AHRQ-funded; HS026122.
Citation: Shipe ME, Beeghly-Fadiel A, Deppen SA .
Modeling the impact of delaying bariatric surgery due to COVID-19: a decision analysis.
Obes Surg 2021 Mar;31(3):1387-91. doi: 10.1007/s11695-020-05054-6..
Keywords: Obesity: Weight Management, Obesity, COVID-19, Surgery, Decision Making
Williams C, Familusi OO, Ziemba J
Adapting to the educational challenges of a pandemic: development of a novel virtual urology subinternship during the time of COVID-19.
The purpose of this study was to design, implement, and evaluate learner attitudes of a virtual urologic surgery clinical rotation for medical students. The investigators concluded that virtual medical student rotations were scalable and effective at delivering surgical material and could approximate the interpersonal teaching found in clinical learning environments. The investigators suggested that they may be a useful tool to supplement or augment clinical learning in select situations.
AHRQ-funded; HS026372.
Citation: Williams C, Familusi OO, Ziemba J .
Adapting to the educational challenges of a pandemic: development of a novel virtual urology subinternship during the time of COVID-19.
Urology 2021 Feb;148:70-76. doi: 10.1016/j.urology.2020.08.071..
Keywords: Education: Curriculum, COVID-19, Surgery, Education: Continuing Medical Education