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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 10 of 10 Research Studies DisplayedFingar KR, Weiss AJ, Roemer M
AHRQ Author: Roemer M, Reid LD
Effects of the COVID-19 early pandemic on delivery outcomes among women with and without COVID-19 at birth.
This AHRQ-authored paper examined the early pandemic-related changes in birth outcomes for pregnant women with and without a COVID-19 diagnosis at delivery. They compared four delivery outcomes-preterm delivery (PTD), severe maternal morbidity (SMM), stillbirth, and cesarean birth-between 2017 and 2019 (prepandemic) and between April and December 2020 (early pandemic) using interrupted time series models on 11.8 million deliveries, stratified by COVID-19 infection status at birth with entropy weighting for historical controls, from the HCUP across 43 states and the District of Columbia. Relative to 2017-2019, women without COVID-19 at delivery in 2020 had lower odds of PTD (OR = 0.93) and SMM (OR = 0.88) but increased odds of stillbirth (OR = 1.04). COVID-19 deliveries had an excess of each outcome, by factors of 1.07-1.46 for outcomes except SMM at 4.21. The effect for SMM was more pronounced for Asian/Pacific Islander non-Hispanic (API; OR = 10.51) and Hispanic (OR = 5.09) pregnant women than for White non-Hispanic (OR = 3.28) women.
AHRQ-authored; AHRQ-funded; 290201800001C.
Citation: Fingar KR, Weiss AJ, Roemer M .
Effects of the COVID-19 early pandemic on delivery outcomes among women with and without COVID-19 at birth.
Birth 2023 Dec; 50(4):996-1008. doi: 10.1111/birt.12753..
Keywords: Healthcare Cost and Utilization Project (HCUP), COVID-19, Maternal Care, Women, Outcomes
Eliason E, Admon LK, Steenland MW
Late postpartum coverage loss before COVID-19: implications for Medicaid unwinding.
The purpose of this study was to explore the loss of Medicaid coverage in toward the end of the postpartum period prior to COVID-19 and describe the implications for Medicaid unwinding. The researchers utilized unique Pregnancy Risk Assessment Monitoring System follow-up data from prior to the COVID-19 pandemic. The study found that only 68% of enrollees in prenatal Medicaid maintained continuous Medicaid coverage through 9 or 10 months postpartum. Of the total prenatal Medicaid enrollees who lost their coverage in the early postpartum period, two-thirds continued to be uninsured 9 to 10 months postpartum. The researchers concluded that extensions to state postpartum Medicaid could prevent a return to postpartum coverage loss rates similar to the level in the prepandemic period.
AHRQ-funded; HS027464; HS000011.
Citation: Eliason E, Admon LK, Steenland MW .
Late postpartum coverage loss before COVID-19: implications for Medicaid unwinding.
Health Aff 2023 Jul; 42(7):966-72. doi: 10.1377/hlthaff.2022.01659..
Keywords: COVID-19, Maternal Care, Medicaid, Women, Access to Care, Uninsured, Health Insurance
Blebu BE, Kuppermann M, Coleman-Phox K
A qualitative exploration of experiences accessing community and social services among pregnant low-income people of color during the COVID-19 pandemic.
The COVID-19 pandemic has led to heightened social and economic stressors for expectant individuals. Although community and social services exist to alleviate stressors during pregnancy (e.g., food insecurity and financial difficulties) and decrease the likelihood of negative maternal outcomes, it remains uncertain how the pandemic influenced access to these resources, especially among low-income communities of color. The purpose of this study was to explore the experiences of low-income pregnant individuals of color in accessing community and social service resources during the COVID-19 pandemic. This qualitative study on COVID-related factors recruited participants from two sources—a prospective comparative effectiveness study comparing two enhanced prenatal care models and the California Black Infant Health Program between August and November 2020. The researchers conducted 62 interviews with Medicaid-eligible participants in California's Central Valley, asking them to describe their pregnancy-related experiences and the perceived impact of the pandemic on these experiences. The study identified two overarching themes: obstacles in accessing community and social service resources during the pandemic and potential avenues for enhancing access to these resources. Sub-themes regarding challenges encountered encompassed issues with remote access, complex registration procedures for community and social services, and concerns specific to COVID-19 resources (e.g., testing). Sub-themes associated with opportunities for improved access included capitalizing on instrumental support from perinatal staff and informational (e.g., practical) support from other community programs and pregnant peers. Participants suggested improved client experiences could be achieved through increased transparency and enhanced patient-provider communication.
AHRQ-funded; HS026407
Citation: Blebu BE, Kuppermann M, Coleman-Phox K .
A qualitative exploration of experiences accessing community and social services among pregnant low-income people of color during the COVID-19 pandemic.
Womens Health 2023 Jan-Dec;19:17455057231156792. doi: 10.1177/17455057231156792.
Keywords: COVID-19, Racial and Ethnic Minorities, Low-Income, Women, Pregnancy, Public Health
Smith AJB, Zhou RA, Sites E
Childbirths at home and in birthing centers rose during COVID-19: Oregon 2020 vs prior years.
This study’s objectives were to compare place of birth between 2020 and years before the COVID-19 pandemic and to investigate whether changes in place of birth differed between system-owned and independent hospitals and urban and rural regions in Oregon. Findings showed that, in Oregon, in-hospital births declined significantly during the first year of COVID-19 and affected system-owned hospitals more than independent ones. Further, shifts toward out-of-hospital births occurred in both urban and rural areas.
AHRQ-funded; HS024072.
Citation: Smith AJB, Zhou RA, Sites E .
Childbirths at home and in birthing centers rose during COVID-19: Oregon 2020 vs prior years.
Am J Obstet Gynecol 2022 Jul;227(1):108-11. doi: 10.1016/j.ajog.2022.03.027..
Keywords: Labor and Delivery, Pregnancy, Women, COVID-19
Eliason EL, Daw JR, Steenland MW
Changes in postpartum insurance coverage in the US during the COVID-19 pandemic.
The purpose of this study was to examine changes in postpartum insurance loss or changes (churn) in Medicaid-insured pregnant people during the COVID-19 pandemic. The researchers utilized the 2019 to 2021 Current Population Survey, Annual Social and Economic Supplement
(CPS-ASEC), with an annual sample size of approximately 98,000 households. The study covered 3 time periods: prepandemic (2019), early pandemic (2020), and pandemic (2021), and included female respondents aged 18 to 44 years who were living with a child
younger than 1 year at the time. Coverage was assigned to one of three categories: private, Medicaid, or uninsured. Churn was defined as loss of insurance or changes in insurance type between current insurance and insurance in the previous year. The study found that in 2019 (before the pandemic), among postpartum respondents with Medicaid during the last year, 88.2% had consistent Medicaid, 10.3% lost coverage, and 1.6%switched to private coverage. In 2021 (during the pandemic), consistent Medicaid increased by 6.8 percentage points and Medicaid-uninsured churn decreased by 6.6 percentage points representing a 64% decline from 2019. The researchers concluded that postpartum insurance loss decreased during the pandemic, primarily associated with large increases in consistent Medicaid coverage, and that these findings suggest that the Families First Coronavirus Response Act, which prevented Medicaid disenrollment, was associated with substantial reductions in postpartum Medicaid loss.
(CPS-ASEC), with an annual sample size of approximately 98,000 households. The study covered 3 time periods: prepandemic (2019), early pandemic (2020), and pandemic (2021), and included female respondents aged 18 to 44 years who were living with a child
younger than 1 year at the time. Coverage was assigned to one of three categories: private, Medicaid, or uninsured. Churn was defined as loss of insurance or changes in insurance type between current insurance and insurance in the previous year. The study found that in 2019 (before the pandemic), among postpartum respondents with Medicaid during the last year, 88.2% had consistent Medicaid, 10.3% lost coverage, and 1.6%switched to private coverage. In 2021 (during the pandemic), consistent Medicaid increased by 6.8 percentage points and Medicaid-uninsured churn decreased by 6.6 percentage points representing a 64% decline from 2019. The researchers concluded that postpartum insurance loss decreased during the pandemic, primarily associated with large increases in consistent Medicaid coverage, and that these findings suggest that the Families First Coronavirus Response Act, which prevented Medicaid disenrollment, was associated with substantial reductions in postpartum Medicaid loss.
AHRQ-funded; HS000011; HS027464.
Citation: Eliason EL, Daw JR, Steenland MW .
Changes in postpartum insurance coverage in the US during the COVID-19 pandemic.
JAMA Health Forum 2022 Apr;3(4):e220688. doi: 10.1001/jamahealthforum.2022.0688..
Keywords: COVID-19, Health Insurance, Maternal Care, Women, Pregnancy
Alagoz O, Lowry KP, Kurian AW
Impact of the COVID-19 pandemic on breast cancer mortality in the US: estimates from collaborative simulation modeling.
This study’s objective was to project the impact of COVID-19 on future breast cancer mortality between 2020 and 2030. Three established Cancer Intervention and Surveillance Modeling Network breast cancer models were used to model reductions in mammography screening use, delays in symptomatic cancer diagnosis, and reduced use of chemotherapy for women with early-stage disease for the first 6 months of the pandemic with return to prepandemic patterns after that time. The models project by 2030 950 cumulative excess breast cancers deaths related to reduced screening, 1314 deaths associated with delayed diagnosis of symptomatic cases, and 151 deaths associated with reduced chemotherapy use in women with hormone positive, early-stage cancer.
AHRQ-funded; HS018366.
Citation: Alagoz O, Lowry KP, Kurian AW .
Impact of the COVID-19 pandemic on breast cancer mortality in the US: estimates from collaborative simulation modeling.
J Natl Cancer Inst 2021 Nov 2;113(11):1484-94. doi: 10.1093/jnci/djab097..
Keywords: COVID-19, Cancer: Breast Cancer, Cancer, Mortality, Women
Barrero-Castillero A, Beam KS, Bernardini LB
COVID-19: neonatal-perinatal perspectives.
This review provides a comprehensive overview of neonatal-perinatal perspectives of COVID-19, ranging from the basic science of infection and recommendations for care of pregnant women and neonates to important psychosocial, ethical, and racial/ethnic topics emerging as a result of both the pandemic and the response of the healthcare community to the care of infected individuals.
AHRQ-funded; HS000063.
Citation: Barrero-Castillero A, Beam KS, Bernardini LB .
COVID-19: neonatal-perinatal perspectives.
J Perinatol 2021 May;41(5):940-51. doi: 10.1038/s41372-020-00874-x..
Keywords: COVID-19, Newborns/Infants, Infectious Diseases, Pregnancy, Women
Miglioretti DL, Bissell MCS, Kerlikowske K
Assessment of a risk-based approach for triaging mammography examinations during periods of reduced capacity.
Breast cancer screening, surveillance, and diagnostic imaging services were profoundly limited during the initial phase of the coronavirus disease 2019 (COVID-19) pandemic. The objective of this population-based cohort study was to develop a risk-based strategy for triaging mammograms during periods of decreased capacity. The investigators found that clinical indication and individual risk factors were associated with cancer detection and suggest these may be useful for prioritizing mammography in times and settings of decreased capacity.
AHRQ-funded; HS018366.
Citation: Miglioretti DL, Bissell MCS, Kerlikowske K .
Assessment of a risk-based approach for triaging mammography examinations during periods of reduced capacity.
JAMA Netw Open 2021 Mar;4(3):e211974. doi: 10.1001/jamanetworkopen.2021.1974..
Keywords: Screening, Cancer: Breast Cancer, Cancer, Women, Imaging, Access to Care, COVID-19
Song H, Bergman A, Chen AT
Disruptions in preventive care: mammograms during the COVID-19 pandemic.
The objective of this study was to measure the extent to which the provision of mammograms was impacted by the COVID-19 pandemic and surrounding guidelines. The data source for the study were de-identified summary data derived from medical claims and eligibility files were provided by Independence Blue Cross for women receiving mammograms. The investigators concluded that the provision of mammograms has been significantly disrupted due to the COVID-19 pandemic.
AHRQ-funded; HS026116.
Citation: Song H, Bergman A, Chen AT .
Disruptions in preventive care: mammograms during the COVID-19 pandemic.
Health Serv Res 2021 Feb;56(1):95-101. doi: 10.1111/1475-6773.13596..
Keywords: COVID-19, Screening, Cancer: Breast Cancer, Cancer, Women, Prevention
Lara OD, O'Cearbhaill RE, Smith MJ
COVID-19 outcomes of patients with gynecologic cancer in New York City.
Researchers studied clinical characteristics and outcomes of vulnerable populations with gynecologic cancer who developed COVID-19 infections. Among patients from six New York City area hospital systems with known gynecologic cancer and a COVID-19 diagnosis, the researchers found a case fatality rate of 14 percent, with no association between cytotoxic chemotherapy and cancer-directed surgery and COVID-19 severity or death. They recommended that patients be counseled regarding the safety of continued anticancer treatments during the pandemic, as the ability to continue cancer therapies for cancer control and cure is critical.
AHRQ-funded; HS026120.
Citation: Lara OD, O'Cearbhaill RE, Smith MJ .
COVID-19 outcomes of patients with gynecologic cancer in New York City.
Cancer 2020 Oct 1;126(19):4294-303. doi: 10.1002/cncr.33084..
Keywords: COVID-19, Respiratory Conditions, Cancer, Women, Vulnerable Populations, Outcomes, Urban Health