National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- (-) Access to Care (6)
- Behavioral Health (1)
- Children/Adolescents (3)
- Chronic Conditions (1)
- (-) COVID-19 (6)
- Disparities (1)
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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 6 of 6 Research Studies DisplayedGriffith KN, Asfaw DA, Childers RG
Changes in US veterans' access to specialty care during the COVID-19 pandemic.
This research letter examined changes in US veterans’ access to specialty care during the COVID-19 pandemic through October 2021. The Veterans Health Administration (VHA) completed 14,516,937 internal referrals and purchased an additional 9,904,132 referrals to community-based specialists during the study period. Before the pandemic VHA specialists completed a mean 452,148 referrals each month. Volume dropped starting in March 2020 and did not fully until recover until March 2021. Peak decline was in April 2020 by 70.7% to 132,481 referrals. Community care referrals declined by 32.9% in June 2020, but rebounded thereafter and exceeded the prepandemic baseline by March 2021. Waits for VHA specialists began rising in June 2020, peaked in July 2020 and returned to prepandemic levels by spring 2021. Mean waits for community specialists peaked in June 2020 and returned to prepandemic baseline levels by August 2020.
AHRQ-funded; HS026395.
Citation: Griffith KN, Asfaw DA, Childers RG .
Changes in US veterans' access to specialty care during the COVID-19 pandemic.
JAMA Netw Open 2022 Sep;5(9):e2232515. doi: 10.1001/jamanetworkopen.2022.32515..
Keywords: COVID-19, Access to Care
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
Reeves SL, Patel PN, Madden B
Telehealth use before and during the COVID-19 pandemic among children with sickle cell anemia.
This study’s goal was to determine telehealth use before and during the COVID pandemic for children ages 1-17 years old with sickle cell anemia (SCA). The authors identified children with SCA continuously enrolled in Michigan Medicaid from January 2019 to December 2020. The study population consisted of 493 children with SCA with a mean age of 8.7 years at study entry. Pre-pandemic there were 4,367 outpatient visits, with all but 19 in-person. Telehealth visits peaked in April 2020 and then began declining. The majority of telehealth visits were with hematologists, followed up adult subspecialists (27%) and pediatrics/family medicine.
AHRQ-funded; HS027632.
Citation: Reeves SL, Patel PN, Madden B .
Telehealth use before and during the COVID-19 pandemic among children with sickle cell anemia.
Telemed J E Health 2022 Aug;28(8):1166-71. doi: 10.1089/tmj.2021.0132..
Keywords: Children/Adolescents, COVID-19, Telehealth, Health Information Technology (HIT), Sickle Cell Disease, Chronic Conditions, Access to 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
Huang J, Graetz I, Millman A
Primary care telemedicine during the COVID-19 pandemic: patient's choice of video versus telephone visit.
The goal of this study was to examine the association between patient characteristics and primary care telemedicine choice among integrated delivery system patients self-scheduling visits during the COVID-19 pandemic. Findings showed that patients of Black or Hispanic race/ethnicity, or living in low socioeconomic status or low internet access neighborhoods were less likely to schedule video visits. Also, patients 65 years or older, with prior video visit experience or mobile portal access, or visiting their own personal provider were more likely to schedule video visits. While video adoption was substantial in all patient groups examined, differences in telemedicine choice suggested the persistence of a digital divide.
AHRQ-funded; HS025189.
Citation: Huang J, Graetz I, Millman A .
Primary care telemedicine during the COVID-19 pandemic: patient's choice of video versus telephone visit.
JAMIA Open 2022 Apr;5(1):ooac002. doi: 10.1093/jamiaopen/ooac002..
Keywords: COVID-19, Primary Care, Telehealth, Health Information Technology (HIT), Access to Care
Kemme S, Yoeli D, Sundaram SS
Decreased access to pediatric liver transplantation during the COVID-19 pandemic.
The purpose of the study was to explore and understand the impact of the COVID-19 pandemic on nationwide pediatric liver transplants. The researchers compared data for transplant waiting list additions, removals, and liver transplants during pre-COVID-19 (March-November 2016-2019), early COVID-19 (March-May 2020), and late COVID-19 (June-November 2020). The study results showed a 38% decrease in liver transplantations during early COVID-19, recovering to pre-pandemic rates during late COVID-19. White children had a 30% decrease in overall liver transplantation, while non-White children had a 44% decrease in overall liver transplantation. Additions to the waiting list decreased 25% during COVID-19, with Black transplant candidates the most affected, and children spent longer on the waiting list during early COVID-19 compared to pre-COVID-19 (140 vs. 96 days). The study concluded that the COVID-19 pandemic decreased access to pediatric liver transplants, especially during early COVID-19. The researchers discussed that although the rate of pediatric liver transplants has resumed to pre-COVID-19 levels, racial disparities must be addressed.
AHRQ-funded; HS026510.
Citation: Kemme S, Yoeli D, Sundaram SS .
Decreased access to pediatric liver transplantation during the COVID-19 pandemic.
Pediatr Transplant 2022 Mar;26(2):e14162. doi: 10.1111/petr.14162..
Keywords: Children/Adolescents, COVID-19, Transplantation, Access to Care, Disparities