National Healthcare Quality and Disparities Report
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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
26 to 40 of 40 Research Studies DisplayedRhee C, Kanjilal S, Baker M
Duration of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infectivity: when is it safe to discontinue isolation?
This review examined the current evidence of when a Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) patient is no longer infectious and no longer needs to be in isolation. Most patients have persistently positive tests for weeks to months following clinical recovery; but this may not indicate their infectivity. SARS-CoV-2 appears to be most contagious around the time of symptom onset. Infectivity decreases to near-zero after about 10 days in mild-moderately ill patients and 15 days in severely-critically ill and immunocompromised patients. The longest interval associated with replication-competent virus found so far is 20 days from symptom onset.
AHRQ-funded; HS025008.
Citation: Rhee C, Kanjilal S, Baker M .
Duration of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infectivity: when is it safe to discontinue isolation?
Clin Infect Dis 2021 Apr 26;72(8):1467-74. doi: 10.1093/cid/ciaa1249..
Keywords: COVID-19, Respiratory Conditions, Public Health, Infectious Diseases
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
O'Donoghue A, Dechen T, O'Donoghue A, Dechen T, Pavlova W W
Reopening businesses and risk of COVID-19 transmission.
In this paper, the authors used anonymized cell-phone data to quantify the potential risk of COVID-19 transmission in business establishments by building a Business Risk Index that measures transmission risk over time. They used two metrics, visits per square foot and the average duration of visits from January 2020 to June 2020. They found that an increase in a county's average Business Risk Index is associated with an increase in positive COVID-19 cases in 1 week. Their risk index provides a way for policymakers and hospital decision-makers to monitor the potential risk of COVID-19 transmission from businesses based on the frequency and density of visits to businesses.
AHRQ-funded; HS024288.
Citation: O'Donoghue A, Dechen T, O'Donoghue A, Dechen T, Pavlova W W .
Reopening businesses and risk of COVID-19 transmission.
NPJ Digit Med 2021 Mar 16;4(1):51. doi: 10.1038/s41746-021-00420-9..
Keywords: COVID-19, Community-Acquired Infections, Public Health, Risk
Teixeira da Silva D, Biello K, Lin WY
COVID-19 vaccine acceptance among an online sample of sexual and gender minority men and transgender women.
Sexual and gender minority (SGM) populations are particularly vulnerable to poor COVID-19 outcomes and are more likely to experience stigma and medical mistrust that may impact COVID-19 vaccine acceptance. This study examined the prevalence of COVID testing and diagnosis and assessed COVID-19 vaccine acceptance among a large sample of SGM. The investigators found that black participants were significantly less likely to accept a COVID-19 vaccine, and Asian participants were significantly more likely to accept a vaccine, compared to White peers.
AHRQ-funded; HS0226116.
Citation: Teixeira da Silva D, Biello K, Lin WY .
COVID-19 vaccine acceptance among an online sample of sexual and gender minority men and transgender women.
Vaccines 2021 Mar;9(3). doi: 10.3390/vaccines9030204..
Keywords: Vaccination, COVID-19, Public Health, Racial and Ethnic Minorities, Vulnerable Populations
Angier H, Garvey B, DeVoe JE. H, Angier H, Garvey B, DeVoe JE. B, DeVoe JE
Focus on families to improve child health during the COVID-19 pandemic and beyond.
This article discusses the need for policymakers to develop interventions designed to help entire families during the pandemic because children’s health is affected by parent health. The authors advocate creating family-centered health care and enable primary care practices and public health programs to help families apply for health insurance coverage. They also discuss work that must be done to address health equity and increasing health and health care disparities caused by the COVID-19 pandemic.
AHRQ-funded; HS025962.
Citation: Angier H, Garvey B, DeVoe JE. H, Angier H, Garvey B, DeVoe JE. B, DeVoe JE .
Focus on families to improve child health during the COVID-19 pandemic and beyond.
JAMA Health Forum 2021 Mar;2(3). doi: 10.1001/jamahealthforum.2021.0238..
Keywords: Children/Adolescents, COVID-19, Family Health and History, Patient-Centered Healthcare, Policy, Public Health
Ye S, Hiura G, Fleck E
Hospital readmissions after implementation of a discharge care program for patients with COVID-19 illness.
The surge of coronavirus 2019 (COVID-19) hospitalizations in New York City required rapid discharges to maintain hospital capacity. The objective of this study was to determine whether lenient provisional discharge guidelines with remote monitoring after discharge resulted in safe discharges home for patients hospitalized with COVID-19 illness. The investigators found that lenient discharge criteria in conjunction with remote monitoring after discharge were associated with a rate of early readmissions after COVID-related hospitalizations that was comparable to the rate of readmissions after other reasons for hospitalization before the COVID pandemic.
AHRQ-funded; HS024262; HS025198.
Citation: Ye S, Hiura G, Fleck E .
Hospital readmissions after implementation of a discharge care program for patients with COVID-19 illness.
J Gen Intern Med 2021 Mar;36(3):722-29. doi: 10.1007/s11606-020-06340-w..
Keywords: COVID-19, Hospital Discharge, Hospital Readmissions, Hospitals, Public Health, Hospitalization, Risk
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
Malloy GSP, Puglisi L, Brandeau ML
Effectiveness of interventions to reduce COVID-19 transmission in a large urban jail: a model-based analysis.
The authors sought to estimate the impact of various mitigation strategies on COVID-19 transmission in a US jail beyond those offered in national guidelines. They found that depopulation, single celling, and asymptomatic testing within jails can be effective strategies to mitigate COVID-19 transmission in addition to standard public health measures. They recommended that decision makers prioritize reductions in the jail population, single celling, and testing asymptomatic populations as additional measures to manage COVID-19 within correctional settings.
AHRQ-funded; HS026128.
Citation: Malloy GSP, Puglisi L, Brandeau ML .
Effectiveness of interventions to reduce COVID-19 transmission in a large urban jail: a model-based analysis.
BMJ Open 2021 Feb 17;11(2):e042898. doi: 10.1136/bmjopen-2020-042898..
Keywords: COVID-19, Public Health, Vulnerable Populations, Prevention, Infectious Diseases
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
Puglisi LB, Malloy GSP, Harvey TD
Estimation of COVID-19 basic reproduction ratio in a large urban jail in the United States.
The purpose of this study was to estimate the basic reproduction ratio () of SARS-CoV-2 inside a correctional facility early in the COVID-19 pandemic. The investigators concluded that the high of SARS-CoV-2 in a large urban jail highlighted the importance of including correctional facilities in public health strategies for COVID-19. The investigators suggested that in the absence of more aggressive mitigation strategies, correctional facilities will continue to contribute to community infections.
AHRQ-funded; HS026128.
Citation: Puglisi LB, Malloy GSP, Harvey TD .
Estimation of COVID-19 basic reproduction ratio in a large urban jail in the United States.
Ann Epidemiol 2021 Jan;53:103-05. doi: 10.1016/j.annepidem.2020.09.002..
Keywords: COVID-19, Public Health, Vulnerable Populations, Prevention, Infectious Diseases
Bramante CT, Ingraham NE, Murray TA
Metformin and risk of mortality in patients hospitalised with COVID-19: a retrospective cohort analysis.
This study examined whether metformin use by patients with diagnosed with type 2 diabetes had reduced mortality when hospitalized for COVID-19. Pharmacy claims data from UnitedHealth Group’s Clinical Discovery Claims Database was used. Patient data were included if they were aged 18 years or older; had type 2 diabetes or obesity (defined based on claims); at least 6 months of continuous enrolment in 2019; and admission to hospital for COVID-19 confirmed by PCR; manual chart review by UHG; or reported from the hospital to UHG. Metformin was not associated with significant reduction in mortality among men, but there was an association with decreased mortality in women.
AHRQ-funded; HS026379.
Citation: Bramante CT, Ingraham NE, Murray TA .
Metformin and risk of mortality in patients hospitalised with COVID-19: a retrospective cohort analysis.
Lancet Healthy Longev 2021 Jan;2(1):e34-e41. doi: 10.1016/s2666-7568(20)30033-7..
Keywords: COVID-19, Hospitalization, Medication, Mortality, Risk, Diabetes, Chronic Conditions, Public Health, Infectious Diseases
Montoya A, Jenq G, Mills JP
Partnering with local hospitals and public health to manage COVID-19 outbreaks in nursing homes.
In this study, the authors described, among short-term and long-term residents at three nursing homes (NHs) in Michigan, the outbreak identification process, universal testing, point prevalence of COVID-19, and subsequent containment efforts, outcomes, and challenges. They found that proactive and coordinated steps between NH medical directors and administrators, referral hospitals including their laboratories, and local public health officials were necessary to respond rapidly to an outbreak and to limit the transmission of COVID-19. They suggested that this coordinated public health approach may save lives, minimize the burden to the healthcare system, and reduce healthcare costs.
AHRQ-funded; HS025451.
Citation: Montoya A, Jenq G, Mills JP .
Partnering with local hospitals and public health to manage COVID-19 outbreaks in nursing homes.
J Am Geriatr Soc 2021 Jan;69(1):30-36. doi: 10.1111/jgs.16869..
Keywords: Hospitals, Nursing Homes, Long-Term Care, Public Health, COVID-19, Elderly, Infectious Diseases
Selden TM, Berdahl TA
AHRQ Author: Selden TM, Berdahl TA
Risk of severe COVID-19 among workers and their household members.
Using prepandemic MEPS data, the investigators examined the prevalence of Centers for Disease Control and Prevention (CDC) risk factors for severe coronavirus disease 2019 (COVID-19). They then estimated how many adults at increased risk of severe COVID-19 held essential jobs and could not work at home (WAH) or who lived in households with such workers.
AHRQ-authored.
Citation: Selden TM, Berdahl TA .
Risk of severe COVID-19 among workers and their household members.
JAMA Intern Med 2021 Jan;181(1):120-22. doi: 10.1001/jamainternmed.2020.6249..
Keywords: Medical Expenditure Panel Survey (MEPS), COVID-19, Risk, Public Health, Infectious Diseases
Balikai SC, Badheka A, Casey A
Simulation to train pediatric ICU teams in endotracheal intubation of patients with COVID-19.
This paper describes the outcomes of pediatric intensive care unit (PICU) simulation training to safely perform endotracheal intubations in children with suspected or confirmed COVID-19. Confidence levels before and after training was measured using the Simulation Effectiveness Tool-Modified (SET-M, Likert scale 0-2). Fifty unique PICU staff members participated in 9 simulation sessions and mean confidences scores increased from 0.9 to 2.
AHRQ-funded; HS026965.
Citation: Balikai SC, Badheka A, Casey A .
Simulation to train pediatric ICU teams in endotracheal intubation of patients with COVID-19.
Pediatr Qual Saf 2021 Jan-Feb;6(1):e373. doi: 10.1097/pq9.0000000000000373..
Keywords: Children/Adolescents, COVID-19, Intensive Care Unit (ICU), Critical Care, Simulation, Training, Public Health, Infectious Diseases
Lee BY, Bartsch SM, Ferguson MC
The value of decreasing the duration of the infectious period of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.
Researchers developed a computational model of the U.S. simulating the spread of SARS-CoV-2 and the potential clinical and economic impact of reducing the infectious period duration. They reported that their study quantifies the potential effects of reducing the SARS-CoV-2 infectious period duration.
AHRQ-funded; HS023317.
Citation: Lee BY, Bartsch SM, Ferguson MC .
The value of decreasing the duration of the infectious period of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.
PLoS Comput Biol 2021 Jan;17(1):e1008470. doi: 10.1371/journal.pcbi.1008470..
Keywords: COVID-19, Respiratory Conditions, Public Health, Prevention, Infectious Diseases