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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 DisplayedMeiselbach MK, Bai G, Anderson GF
Charges of COVID-19 diagnostic testing and antibody testing across facility types and states.
The authors discuss the practice of high charges for COVID-19 testing by some healthcare providers, with the charges for COVID-19 testing having important implications for uninsured patients, out-of-network services, and other payers without negotiating power. The purpose of this study was to examine the charges for the most commonly performed COVID-19 diagnostic test and antibody test across facility types and states. The study found that for COVID-19 diagnostic testing, the mean, median, and standard deviations of charges were $144.06, $100.00, and $162.18. The most common facility type was independent laboratories (performing 49.7% of all tests), with an average charge of $140.41, followed by hospital outpatient settings (performing 34.5% of all tests), with an average charge of $168.87. For antibody testing, the mean, median, and standard deviations of charges were $63.93, $55.00, and $48.92. Independent laboratories performed 97.2% of all tests, with an average charge of $62.30. In sum, 8.0% of diagnostic testing services and 14.0% of antibody testing claims were charged one standard deviation above the mean ($306.24 for diagnostic testing and $112.85 for antibody testing). The state average testing charges ranged between $64.98 (UT) and $505.65 (DC) for diagnostic testing, and $45.85 (NY) and $195.41 (NM) for antibody testing. AR, LA, MO, and NM had high average charges for both tests. GA, KS, MA, MD, NC, NV, and OK had low charges for both tests. No statistically significant association was found between testing charges and state-level testing rates, infection rates, or mortality rates.
AHRQ-funded; HS000029.
Citation: Meiselbach MK, Bai G, Anderson GF .
Charges of COVID-19 diagnostic testing and antibody testing across facility types and states.
J Gen Intern Med 2023 Dec; 38(16):3640-43. doi: 10.1007/s11606-020-06198-y..
Keywords: COVID-19, Diagnostic Safety and Quality, Healthcare Costs
Ferranna M, Robinson LA, Cadarette D
The benefits and costs of U.S. employer COVID-19 vaccine mandates.
This study examined the benefits and costs of U.S. employer COVID-19 mandates for federal employees and contractors and for some healthcare and private sector workers if there had not been major challenges in court that halted or delayed the mandates. The authors estimated the direct costs and health-related benefits that would have accrued if these vaccination requirements had been implemented as intended. Compared with the January 2022 vaccination rates, they found that the mandates could have led to 15 million additional vaccinated individuals, increasing the overall proportion of the fully vaccinated U.S. population from 64% to 68%. They examined scenarios involving the emergence of a novel, more transmissible variant, against which vaccination and previous infection offer moderate protection, and found that the estimated net benefits are potentially large. They estimated that they reach almost $20,000 per additional vaccinated individual, with more than 20,000 total deaths averted over the 6-month period assessed. For other scenarios involving a fading pandemic, existing vaccination-acquired or infection-acquired immunity provides sufficient protection, and the mandates' benefits are unlikely to exceed their costs. They believe that mandates may be most useful when the consequences of inaction are catastrophic. However, they did not compare the effects of mandates with alternative policies for increasing vaccination rates or for promoting other protective measures, which may receive stronger public support and be less likely to be overturned by litigation.
AHRQ-funded; HS000055.
Citation: Ferranna M, Robinson LA, Cadarette D .
The benefits and costs of U.S. employer COVID-19 vaccine mandates.
Risk Anal 2023 Oct; 43(10):2053-68. doi: 10.1111/risa.14090..
Keywords: COVID-19, Vaccination, Healthcare Costs
Becker NV, Carlton EF, Iwashyna TJ
Patient adverse financial outcomes before and after COVID-19 infection.
This study’s goal was to assess whether more adverse financial outcomes occurred after COVID-19 infection and hospitalization compared to those who were not hospitalized with COVID-19. The authors used credit report data from 132,109 commercially insured COVID-19 survivors to compare the rates of adverse financial outcomes for two cohorts of individuals with credit outcomes measured before and after COVID-19 infection, using an interaction term between cohort and hospitalization to test whether adverse credit outcomes changed more for hospitalized than nonhospitalized COVID-19 patients. There were greater adverse financial outcomes among persons hospitalized with COVID-19 (5-8 percentage points) than non-hospitalized COVID-19 patients (1-3 percentage points).
AHRQ-funded; HS028672; HS028817.
Citation: Becker NV, Carlton EF, Iwashyna TJ .
Patient adverse financial outcomes before and after COVID-19 infection.
J Hosp Med 2023 May; 18(5):424-28. doi: 10.1002/jhm.13105..
Keywords: COVID-19, Healthcare Costs, Hospitalization
Encinosa W, Moon K, Figueroa J
AHRQ Author: Encinosa W
Complications, adverse drug events, high costs, and disparities in multisystem inflammatory syndrome in children vs COVID-19.
This cross-sectional study’s goal was to determine outcomes from multisystem inflammatory syndrome in children (MIS-C) after COVID-19. Outcomes examined were 50 complications, adverse medication events, costs, and the Social Vulnerability Index. An analysis was conducted using data from the 2021 HCUP in individuals younger than 21 years from 31 states. There were 4107 individuals hospitalized with MIS-C (median age 9 years, 59.5% male, 38.1% White) and 23,686 hospitalizations for COVID-19 without MIS-C (median age 15 years, 54.5% female, 44.1% White). Hospitalization rate for MIS-C was 1.48 per 100,000 children, ranging from 0.97 hospitalizations per 100 for White and 1.99 hospitalizations per 100 for Black children. Outcomes were worse when organ dysfunction increased from 2 to 8 organs, with deaths increasing from less than 1% to 5.8% for MIS-C, and 1% to 17.2% for COVID-19. Median length of stay increased from 4 to 8 days for MIS-C, and 3 to 16 days for COVID-19. Median costs for MIS-C increased from $16,225 to $53 359 and from $6474 to $98,643 for COVID-19. The percentage of MIS-C cases in Black children doubled from 16.2% to 31.7% as organ dysfunction increased, remaining unchanged with COVID-19.
AHRQ-authored.
Citation: Encinosa W, Moon K, Figueroa J .
Complications, adverse drug events, high costs, and disparities in multisystem inflammatory syndrome in children vs COVID-19.
JAMA Netw Open 2023 Jan;6(1):e2244975. doi: 10.1001/jamanetworkopen.2022.44975..
Keywords: Healthcare Cost and Utilization Project (HCUP), Children/Adolescents, COVID-19, Medication, Adverse Drug Events (ADE), Adverse Events, Healthcare Costs, Disparities, Racial and Ethnic Minorities
Robinson LA, Eber MR, Hammitt JK
Valuing COVID-19 morbidity risk reductions.
The authors described and implemented an approach for approximating the value of averting nonfatal illnesses or injuries and applied it to COVID-19 in the United States. They estimated gains from averting COVID-19 morbidity of about 0.01 quality-adjusted life year (QALY) per mild case averted, 0.02 QALY per severe case, and 3.15 QALYs per critical case. They indicated that these gains translate into monetary values of about $5,300 per mild case, $11,000 per severe case, and $1.8 million per critical case.
AHRQ-funded; HS000055.
Citation: Robinson LA, Eber MR, Hammitt JK .
Valuing COVID-19 morbidity risk reductions.
J Benefit Cost Anal 2022 Summer;13(2):247-68. doi: 10.1017/bca.2022.11.
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Keywords: COVID-19, Risk, Healthcare Costs
Zuvekas SH, Kashihara D
AHRQ Author: Zuvekas SH
The impacts of the COVID-19 pandemic on the Medical Expenditure Panel Survey.
The COVID-19 pandemic caused substantial disruptions in the field operations of all 3 major components of the Medical Expenditure Panel Survey (MEPS). In this study, the investigators described how the MEPS program successfully responded to these challenges by reengineering field operations, including survey modes, to complete data collection and maintain data release schedules.
AHRQ-authored.
Citation: Zuvekas SH, Kashihara D .
The impacts of the COVID-19 pandemic on the Medical Expenditure Panel Survey.
Am J Public Health 2021 Dec;111(12):2157-66. doi: 10.2105/ajph.2021.306534..
Keywords: Medical Expenditure Panel Survey (MEPS), COVID-19, Healthcare Costs, Data
Bartsch SM, O'Shea KJ, Wedlock PT
The benefits of vaccinating with the first available COVID-19 coronavirus vaccine.
This study’s objective was to determine quantitatively the benefits of early vaccination for COVID-19 even if later on in the pandemic a latter vaccine has substantially higher efficacy. The team developed this model in 2020 before vaccinations became available. For example if a vaccine with 50% efficacy becomes available when 10% of the population has already been infected, waiting until 40% of the population are infected for a vaccine with 80% efficacy results in 15.6 million additional cases and 1.5 million additional hospitalizations, costing $20.6 billion more in direct medical costs and $12.4 billion more in productivity losses.
AHRQ-funded; HS028165.
Citation: Bartsch SM, O'Shea KJ, Wedlock PT .
The benefits of vaccinating with the first available COVID-19 coronavirus vaccine.
Am J Prev Med 2021 May;60(5):605-13. doi: 10.1016/j.amepre.2021.01.001..
Keywords: COVID-19, Vaccination, Healthcare Costs, Prevention, Infectious Diseases
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
Bartsch SM, Ferguson MC, McKinnell JA
The potential health care costs and resource use associated with COVID-19 in the United States.
The authors developed a Monte Carlo simulation model representing the U.S. Population and what can happen to every person who gets infected with COVID-19. The goal was to estimate resource use and direct medical costs per infection at the national level at different infection rates. They found that a single symptomatic COVID-19 infection would cost a median of $3,045 in direct medical costs. If 80% of the population got infected it would cost $654.0 billion in direct costs during the course of the pandemic. If 20% were to become infected, direct costs are estimated at $163.4 billion.
AHRQ-funded; HS023317.
Citation: Bartsch SM, Ferguson MC, McKinnell JA .
The potential health care costs and resource use associated with COVID-19 in the United States.
Health Aff 2020 Jun;39(6):927-35. doi: 10.1377/hlthaff.2020.00426..
Keywords: Healthcare Cost and Utilization Project (HCUP), Healthcare Costs, COVID-19, Healthcare Utilization