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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
76 to 100 of 329 Research Studies DisplayedHsueh L, Huang J, Millman AK
Cross-sectional association of patient language and patient-provider language concordance with video telemedicine use among patients with limited English proficiency.
The surge in telemedicine use during the COVID-19 pandemic underscores the need to address gaps in patient care, particularly for individuals with limited English proficiency. The purpose of this study was to investigate the relationship between patient language, patient-provider language alignment, and the type of telemedicine visit (video or phone consultation). The researchers conducted a cross-sectional analysis using automated data from primary care telemedicine appointments scheduled between March 16, 2020, and October 31, 2020 within a comprehensive healthcare delivery system in Northern California. A total of 22,427 completed primary care telemedicine visits booked by 13,764 patients with limited English proficiency through the patient portal. The study examined the cross-sectional link between electronic health record-documented patient language (with Spanish as the reference) and patient-provider language concordance, considering patient demographics, technology access, and technology familiarity. RESULTS: The study found that among all scheduled appointments, 34.5% (n=7747) were video consultations. The three most common patient languages were Spanish (42.4%), Cantonese (16.9%), and Mandarin (10.3%). After adjusting for demographic and technology factors, video visit usage was higher for patients speaking Cantonese, Mandarin, or Vietnamese, compared to Spanish-speaking patients, but lower for those who spoke Punjabi. Language concordance was linked to decreased video visit utilization and influenced the relationship between speaking Spanish, Cantonese, and Korean with video visit usage. Furthermore, for all language groups, patients with prior video visit experience were more likely to use video visits again.
AHRQ-funded; HS025189
Citation: Hsueh L, Huang J, Millman AK .
Cross-sectional association of patient language and patient-provider language concordance with video telemedicine use among patients with limited English proficiency.
J Gen Intern Med 2023 Feb;38(3):633-40. doi: 10.1007/s11606-022-07887-6.
Keywords: Telehealth, Health Information Technology (HIT), Cultural Competence, Clinician-Patient Communication, Communication, Healthcare Delivery, COVID-19
Becker NV, Seelye S, Chua KP
Dispensing of ivermectin from Veterans Administration pharmacies during the COVID-19 pandemic.
The purpose of this cohort study was to evaluate changes between the Veterans Administration and retail pharmacies in how ivermectin was dispensed during the COVID-19 pandemic. Additionally, this study examined the association of the VA national formulary restriction with ivermectin dispensing. The study concluded that ivermectin dispensing minimally increased in VA pharmacies during the COVID-19 pandemic compared to more significant increases in retail pharmacies. This cohort study found that, in contrast to retail pharmacies, Study limitations include lack of complete capture of all retail pharmacies in IQVIA data and the lack of a control group for the analysis of the VA formulary restriction.
AHRQ-funded; HS028817.
Citation: Becker NV, Seelye S, Chua KP .
Dispensing of ivermectin from Veterans Administration pharmacies during the COVID-19 pandemic.
JAMA Netw Open 2023 Feb; 6(2):e2254859. doi: 10.1001/jamanetworkopen.2022.54859..
Keywords: COVID-19, Medication
Djulbegovic B, Hozo I, Lizarraga D
Evaluation of a fast-and-frugal clinical decision algorithm ('pathways') on clinical outcomes in hospitalised patients with COVID-19 treated with anticoagulants.
The objective of this study was to assess if delivery of anticoagulant prophylaxis according to an algorithm improved clinical outcomes in patients hospitalized with COVID-19 in comparison with anticoagulant treatment given at individual practitioners' discretion. Findings indicated that the algorithm did not reduce death, venous thromboembolism, nor major bleeding, but helped avoid longer hospital stay and admission to an intensive-care unit.
AHRQ-funded; HS024917.
Citation: Djulbegovic B, Hozo I, Lizarraga D .
Evaluation of a fast-and-frugal clinical decision algorithm ('pathways') on clinical outcomes in hospitalised patients with COVID-19 treated with anticoagulants.
J Eval Clin Pract 2023 Feb; 29(1):3-12. doi: 10.1111/jep.13780..
Keywords: COVID-19, Clinical Decision Support (CDS), Blood Thinners, Medication, Evidence-Based Practice, Health Information Technology (HIT)
Kumar V, Encinosa W
AHRQ Author: Encinosa W
Racial disparities in the perceived risk of COVID-19 and in getting needed medical care.
This AHRQ-authored study examined racial and ethnic disparities in eight measures on the perceived risks of COVID-19. The authors used the nationally representative Stanford University School of Medicine Coronavirus Attitudes and Behaviors Survey fielded in May of 2020. Black respondents were 15 percentage points more likely than White respondents to believe the pandemic would not end by Summer 2020 (92% vs 77%), and were 19 percentage points more likely than any other race to feel a need to protect their family from COVID-19 (81% vs 62%). Latinx respondents were 10 percentage points more fearful than White respondents of catching COVID-19 in public places (55% vs 45%). Black respondents were 20 percentage points more likely than White respondents to think they would need medical care if infected (71% vs 51%), and 18 percentage points more likely to think they would need to be hospitalized (59% vs 41%). The proportion of Black respondents believing that the hospital would not have enough capacity to treat them if infected with COVID-19 was 12 percentage points higher than White respondents (41% vs 29%).
AHRQ-authored.
Citation: Kumar V, Encinosa W .
Racial disparities in the perceived risk of COVID-19 and in getting needed medical care.
J Racial Ethn Health Disparities 2023 Feb; 10(1):4-13. doi: 10.1007/s40615-021-01191-5..
Keywords: COVID-19, Racial and Ethnic Minorities, Disparities
Westley L, Manworren RCB, Griffith DM
Using hospital incident command systems to respond to the pediatric mental and behavioral health crisis of the COVID-19 pandemic.
The purpose of this study was to quantify issues related to hospital incident command systems (HICS) implemented to expand mental and behavioral healthcare (MBHC) services during the COVID-19 pandemic, and track progress toward HICS goals. The researchers analyzed data on patient census, nurse vacancies, staff injuries, and staff perceptions and resources were developed. The study found that after HICS implementation, 84% of nurses reported confidence in providing care to youth with acute MBHC needs.
AHRQ-funded; HS026385.
Citation: Westley L, Manworren RCB, Griffith DM .
Using hospital incident command systems to respond to the pediatric mental and behavioral health crisis of the COVID-19 pandemic.
J Nurs Adm 2023 Feb; 53(2):96-103. doi: 10.1097/nna.0000000000001254..
Keywords: COVID-19, Children/Adolescents, Behavioral Health, Hospitals
Barton AJ, Amura CR, Willems EL
Patient and provider perceptions of COVID-19-driven telehealth use from nurse-led care models in rural, frontier, and urban Colorado communities.
The aim of this study was to describe the patient and provider encounter in the unexpected telehealth application that took place with the onset of the COVID-19 pandemic. Patients and providers from 3 nurse-led models of care (federally qualified health centers, nurse midwifery practices, and the Nurse-Family partnership program) in Colorado were surveyed. Data from the Patient Attitude toward Telehealth survey and Provider Perceptions about Telehealth were collected. Patients who resided in urban areas utilized telehealth with greater frequency than in rural or frontier areas. Across each of the 5 domains assessed, rural/frontier patients had significantly lower attitude scores than urban patients. The mode of Telehealth employed differed across location, with video calls utilized more frequently by urban providers, and phone calls utilized by rural/frontier providers.
AHRQ-funded; HS028085.
Citation: Barton AJ, Amura CR, Willems EL .
Patient and provider perceptions of COVID-19-driven telehealth use from nurse-led care models in rural, frontier, and urban Colorado communities.
J Patient Exp 2023 Jan 25; 10:23743735231151546. doi: 10.1177/23743735231151546..
Keywords: COVID-19, Telehealth, Primary Care, Patient Experience, Rural Health, Urban Health, Vulnerable Populations, Provider: Nurse
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
Aiken LH, Sloane DM, McHugh MD
A repeated cross-sectional study of nurses immediately before and during the COVID-19 pandemic: Implications for action
The goal of this cross-sectional study was to establish whether hospital nursing care shortages are primarily due to the COVID pandemic, and therefore likely to subside, or if shortages are due to understaffing and poor working conditions that predated the pandemic. The study considered registered nurses in New York and Illinois, and a subset of staff nurses employed in 357 hospitals, before and during the pandemic. While no evidence was found to show that large numbers of nurses left in the first 18 months of the pandemic, the study’s findings indicate that nurses in hospitals with better staffing and more favorable work environments prior to the pandemic reported significantly better outcomes. The authors concluded that policies that prevent chronic understaffing have the most potential to stabilize the hospital nurse workforce.
AHRQ-funded; HS028978.
Citation: Aiken LH, Sloane DM, McHugh MD .
A repeated cross-sectional study of nurses immediately before and during the COVID-19 pandemic: Implications for action
Nurs Outlook 2023 Jan-Feb; 71(1):101903. doi: 10.1016/j.outlook.2022.11.007..
Keywords: COVID-19, Provider: Nurse, Workforce, Burnout
Auty SG, Aswani MS, Wahbi RN
Changes in health care access by race, income, and Medicaid expansion during the COVID-19 pandemic.
This study examined changes in access to care during the COVID-19 pandemic, stratified by race/ethnicity, household income, and state Medicaid expansion status. Data were extracted for all adults (N = 1,731,699) aged 18-64 surveyed in the 2015-2020 Behavioral Risk Factor Surveillance System from all 50 states and the District of Columbia. The pandemic was associated with a 1.2 percentage point decline in uninsurance for Medicaid expansion states, with reductions concentrated among respondents who were Black, multiracial, or low income. Rates of uninsurance were generally stable in nonexpansion states. Rates of avoided care because of cost fell by 3.5 percentage points in Medicaid expansion states, and by 3.6 percentage points in nonexpansion states. These declines were also concentrated among minority or low-income respondents.
AHRQ-funded; HS026395.
Citation: Auty SG, Aswani MS, Wahbi RN .
Changes in health care access by race, income, and Medicaid expansion during the COVID-19 pandemic.
Med Care 2023 Jan;61(1):45-49. doi: 10.1097/mlr.0000000000001788..
Keywords: COVID-19, Access to Care, Medicaid, Public Health, Racial and Ethnic Minorities, Low-Income
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
Thompson KA, Hedlund EL, Sun Q
Course and predictors of eating disorder symptoms, anxiety symptoms, and pandemic-related eating disorder concerns among adults with eating disorders during the first year of the COVID-19 pandemic.
The purpose of this study was to assess changes in and predictors of Eating Disorder (ED) symptoms, ED concerns related to the COVID-19 pandemic, and anxiety symptoms within the first 12 months of the COVID-19 pandemic among individuals with self-reported EDs in the United States, Sweden, and the Netherlands. The researchers administered an online survey to participants, evaluating ED symptoms, general anxiety symptoms, pandemic-related ED worries about accessing food, lack of structure and social support, being in a triggering environment, and costs of food and treatment. The study found that 3 patterns were evident: 1) a curvilinear progression with the greatest level of symptoms at baseline, declining through November 2020, and then increasing through the remainder of the year; 2) a linear declining progression; and 3) a stable progression with no variations. The researchers reported that concerns about COVID-19 infection, lockdown, worries about lack of structure and social support, and worries about accessing food aligned with their recovery meal plan predicted increases in ED symptoms.
AHRQ-funded.
Citation: Thompson KA, Hedlund EL, Sun Q .
Course and predictors of eating disorder symptoms, anxiety symptoms, and pandemic-related eating disorder concerns among adults with eating disorders during the first year of the COVID-19 pandemic.
Int J Eat Disord 2023 Jan; 56(1):151-68. doi: 10.1002/eat.23870..
Keywords: COVID-19, Behavioral Health, Anxiety
Thomson J, Richardson T, Auger KA
Impact of the COVID-19 pandemic on hospitalizations of children with neurologic impairment.
The purpose of this multicenter retrospective cohort study was to explore the effect of the early COVID-19 pandemic on hospital utilization for children with neurologic impairment (NI). The study found that compared with the pre-COVID period, there was a 14.4% decrease in the weekly median number of hospitalizations in the early-COVID era. Hospitalizations decreased for both noninfectious and infectious illnesses in the early-COVID era. Researchers reported that the decrease was the largest in spring 2020 and continued throughout 2020.
AHRQ-funded; HS024735; HS025138; HS026763.
Citation: Thomson J, Richardson T, Auger KA .
Impact of the COVID-19 pandemic on hospitalizations of children with neurologic impairment.
J Hosp Med 2023 Jan; 18(1):33-42. doi: 10.1002/jhm.13021..
Keywords: Children/Adolescents, COVID-19, Neurological Disorders, Hospitalization
Holmer HK, Mackey K, Fiordalisi CV
Major update 2: antibody response and risk for reinfection after SARS-CoV-2 infection-final update of a living, rapid review.
This paper is a final updated living rapid review to synthesize evidence on the SARS-CoV-2 antibody response and reinfection risk with a focus on gaps identified in the author’s prior reports. A literature review was done for English-language cohort studies evaluating IgG antibody duration at least 12 months after SARS-CoV-2 infection, the antibody response among immunocompromised adults, predictors of nonseroconversion, and reinfection risk. Study data was extracted and two investigators rated quality. Most adults had IgG antibodies after SARS-CoV-2 infection at time points greater than 12 months. Although most immunocompromised adults develop antibodies, the overall proportion with antibodies is lower compared with immunocompetent adults. Prior infection provided substantial, sustained protection against symptomatic reinfection with the Delta variant (high strength of evidence) and reduced the risk for severe disease due to Omicron variant (moderate strength of evidence). Prior infection was less protective against reinfection with Omicron overall (moderate strength of evidence), but protection from earlier variants waned rapidly (low strength of evidence).
AHRQ-funded; 290201700003C.
Citation: Holmer HK, Mackey K, Fiordalisi CV .
Major update 2: antibody response and risk for reinfection after SARS-CoV-2 infection-final update of a living, rapid review.
Ann Intern Med 2023 Jan; 176(1):85-91. doi: 10.7326/m22-1745..
Keywords: COVID-19, Evidence-Based Practice, Infectious Diseases, Risk
Ho M, Tadrous M, Iacono A
Outpatient purchasing patterns of hydroxychloroquine and ivermectin in the USA and Canada during the COVID-19 pandemic: an interrupted time series analysis from 2016 to 2021.
The authors explored the impact of scientific articles, public announcements, and social media posts on hydroxychloroquine and ivermectin purchases in the US and Canada during the COVID-19 pandemic. Their findings indicated that there were significant pulse increases in hydroxychloroquine purchases in March 2020; significant pulse increases in ivermectin occurred from December 2020 to January 2021. The authors concluded that increased hydroxychloroquine and ivermectin purchasing rates aligned with controversial scientific articles and social media posts, and that these findings highlighted the importance of scientific integrity as well as the dissemination of accurate epidemiologic information during pandemics.
AHRQ-funded; HS027985.
Citation: Ho M, Tadrous M, Iacono A .
Outpatient purchasing patterns of hydroxychloroquine and ivermectin in the USA and Canada during the COVID-19 pandemic: an interrupted time series analysis from 2016 to 2021.
J Antimicrob Chemother 2023 Jan;78(1):242-51. doi: 10.1093/jac/dkac382..
Keywords: COVID-19, Medication, Ambulatory Care and Surgery
Huang J, Gopalan A, Muelly E
Primary care video and telephone telemedicine during the COVID-19 pandemic: treatment and follow-up health care utilization.
Researchers compared treatment and follow-up care between video and telephone visits during the COVID-19 pandemic in order to evaluate the efficiency and safety of telemedicine. Return visits were not common and downstream emergency events were rare among telemedicine visits with primary care clinicians. Adjusted rates of treatment measures were higher and adjusted rates of follow-up care were lower for video visits than they were for telephone visits. Although video visits were slightly more efficient than telephone visits, the researchers concluded that telephone visits might offer an accessible option to meet patients’ primary care needs without raising health safety concerns.
AHRQ-funded; HS025189.
Citation: Huang J, Gopalan A, Muelly E .
Primary care video and telephone telemedicine during the COVID-19 pandemic: treatment and follow-up health care utilization.
Am J Manag Care 2023 Jan; 29(1):e13-e17. doi: 10.37765/ajmc.2023.89307..
Keywords: COVID-19, Telehealth, Health Information Technology (HIT)
Sirkin JT, Flanagan E, Tong ST
AHRQ Author: Tong ST, McNellis RJ, Bierman AS
Primary care's challenges and responses in the face of the COVID-19 pandemic: insights from AHRQ's learning community.
The purpose of this paper was to review the Agency for Healthcare Research and Quality’s (AHRQ) learning community organized to engage and support primary care in responding to COVID-19 and provide an opportunity for participants to communicate learning and peer support, improve understanding of the stressors and challenges faced by practices, determine needs, and identify possible solutions to challenges of the pandemic. The researchers identified challenges, responses, and innovations that occurred through the engagement and information sharing of the learning community and categorized them across 5 domains, including: patient-centeredness, clinician and practice, systems and infrastructure, community and public health; and health equity which cut across each of the other domains. The authors concluded that the learning community provided valuable insights for future research and policy, primary care delivery improvement, and ensuring greater preparedness for future challenges.
AHRQ-authored.
Citation: Sirkin JT, Flanagan E, Tong ST .
Primary care's challenges and responses in the face of the COVID-19 pandemic: insights from AHRQ's learning community.
Ann Fam Med 2023 Jan-Feb; 21(1):76-82. doi: 10.1370/afm.2904..
Keywords: COVID-19, Primary Care, Learning Health Systems, Health Systems, Evidence-Based Practice, Public Health
Kravchenko OV, Boyce RD, Gomez-Lumbreras A
Drug-drug interaction between dexamethasone and direct-acting oral anticoagulants: a nested case-control study in the national COVID cohort collaborative (N3C).
This study examined whether there is an association between thromboembolotic events (TEEs) and concomitant use of dexamethasone with either apixaban or rivaroxaban (both direct oral anticoagulants or DOACs) during treatment for COVID-19. The authors used data from the National COVID Cohort Collaborative (N3C) to conduct a nested case-control study. Eligible participants were adults over 18 years who were exposed to a DOAC for 10 or more consecutive days and exposure to dexamethasone at least 5 or more consecutive days. The study did not find a discernible association of TEE in patients concomitantly exposed to dexamethasone and a DOAC.
AHRQ-funded; HS025984.
Citation: Kravchenko OV, Boyce RD, Gomez-Lumbreras A .
Drug-drug interaction between dexamethasone and direct-acting oral anticoagulants: a nested case-control study in the national COVID cohort collaborative (N3C).
BMJ Open 2022 Dec 29; 12(12):e066846. doi: 10.1136/bmjopen-2022-066846..
Keywords: COVID-19, Blood Thinners, Medication, Adverse Drug Events (ADE), Adverse Events, Cardiovascular Conditions, Medication: Safety, Patient Safety
Peng L, Luo G, Walker A
Evaluation of federated learning variations for COVID-19 diagnosis using chest radiographs from 42 US and European hospitals.
The goals of this study were to compare a single-site, COVID-19 computer diagnosis system that used the Federated Averaging (FedAvg) algorithm with 3-client Federated learning (FL) models, and to evaluate the performance of the four FL variations. Researchers leveraged a FL healthcare collaborative that included data from five US and European healthcare systems encompassing 42 hospitals. They concluded that FedAvg could significantly improve generalization of the model in comparison with other personalization FL algorithms--FedProx, FedBN, and FedAMP--but at the cost of poor internal validity.
AHRQ-funded; HS026379.
Citation: Peng L, Luo G, Walker A .
Evaluation of federated learning variations for COVID-19 diagnosis using chest radiographs from 42 US and European hospitals.
J Am Med Inform Assoc 2022 Dec 13;30(1):54-63. doi: 10.1093/jamia/ocac188..
Keywords: COVID-19, Diagnostic Safety and Quality, Imaging, Hospitals
Badaki-Makun O, Levin S, Debraine A
Monocyte distribution width as a pragmatic screen for SARS-CoV-2 or influenza infection.
The purpose of this prospective cohort analysis was to determine the performance of Monocyte distribution width (MDW) and other leukocyte parameters as screening tests for SARS-CoV-2 and influenza infection. Researchers conducted an observational study with a cohort analysis consisting of adult patients who underwent complete blood count (CBC) and SARS-CoV-2 or influenza testing in an Emergency Department (ED) between January 2020 and July 2021. The study concluded that MDW, when available as part of a routine complete blood count (CBC) with differential, could be a useful indicator of SARS-CoV-2 or influenza infection.
AHRQ-funded; HS02664002.
Citation: Badaki-Makun O, Levin S, Debraine A .
Monocyte distribution width as a pragmatic screen for SARS-CoV-2 or influenza infection.
Sci Rep 2022 Dec 13; 12(1):21528. doi: 10.1038/s41598-022-24978-w..
Keywords: COVID-19, Influenza, Respiratory Conditions
Fan CA, Hara-Hubbard KK, Barrington WE
The experience of hate incidents across racial and ethnic groups during the COVID-19 pandemic.
This article investigated the prevalence of hate incidents across racial and ethnic groups and the relationship between race/ethnicity and hate incidents during the first year of the COVID-19 pandemic. National data was taken from the Understanding America Study COVID-19 Longitudinal Survey. The majority of members of all six marginalized racial and ethnic groups reported at least one hate incident; Asian, AI/AN, Black, and Multiracial groups were shown to have significantly higher odds of experiencing each category of hate incident. All marginalized groups had higher odds of receiving poorer service. The authors concluded that the health community must research and treat hate incidents as a public health issue while recognizing the contexts of structural and interpersonal racism in the U.S.
AHRQ-funded; HS013853.
Citation: Fan CA, Hara-Hubbard KK, Barrington WE .
The experience of hate incidents across racial and ethnic groups during the COVID-19 pandemic.
Front Public Health 2022 Dec 12; 10:982029. doi: 10.3389/fpubh.2022.982029..
Keywords: COVID-19, Racial and Ethnic Minorities
Powell KR, Winkler AE, Liu J
A mixed-methods analysis of telehealth implementation in nursing homes amidst the COVID-19 pandemic.
The objective of this study was to investigate the implementation of telehealth in nursing homes during the COVID-19 pandemic. Researchers conducted a secondary analysis of data from a national survey of nursing home administrative leaders using six survey questions and semi-structured interviews. Their conclusions indicate that training, restructuring teams and tasks, and adaptation of work processes to support communication could improve usability and sustainability of telehealth in nursing homes.
AHRQ-funded; HS02249.
Citation: Powell KR, Winkler AE, Liu J .
A mixed-methods analysis of telehealth implementation in nursing homes amidst the COVID-19 pandemic.
J Am Geriatr Soc 2022 Dec;70(12):3493-502. doi: 10.1111/jgs.18020..
Keywords: COVID-19, Elderly, Telehealth, Health Information Technology (HIT), Nursing Homes, Implementation
Meyer AND, Singh H, Zimolzak AJ
Cancer evaluations during the COVID-19 pandemic: an observational study using National Veterans Affairs data.
This observational study examined the reasons why fewer cancer diagnoses have been made during the COVID-19 pandemic using electronic health record data from the Department of Veterans Affairs before (March 10, 2019-March 7, 2020) and during (March 8, 2020-March 6, 2021) the pandemic. Electronic triggers were applied to 8,021,406 veterans' electronic health records to identify follow-up delays for abnormal results warranting evaluation for 5 cancers: bladder, breast, colorectal, liver, and lung cancers. Between the prepandemic and pandemic periods, test quantities decreased by 12.6%-27.8%, and proportions of abnormal results lacking follow-up decreased for urinalyses by 0.8%, increased by 2.3% for fecal occult blood tests/fecal immunochemical test and 1.8% for chest imaging, and remained constant for the other diagnostic tests (mammograms for breast cancer and elevated alpha-fetoprotein for liver cancer). This significant decrease in diagnostic testing may have led to reduced cancer rates.
AHRQ-funded; HS027363.
Citation: Meyer AND, Singh H, Zimolzak AJ .
Cancer evaluations during the COVID-19 pandemic: an observational study using National Veterans Affairs data.
Am J Prev Med 2022 Dec;63(6):1026-30. doi: 10.1016/j.amepre.2022.07.004..
Keywords: COVID-19, Cancer, Public Health
Borgatti AC, Crockett KB, Jacob AE
Correlates of psychological distress among adults with obesity during the COVID-19 pandemic.
The objective of this study was to evaluate changes in stress and loneliness among participants with obesity who were engaged in weight loss self-management in the US during COVID-19, and to identify risk factors that may increase psychosocial distress during this period. Participants completed an online survey about social, economic and health behavior changes during COVID-19 and their relationship to changes in perceived stress and loneliness. Results indicated that stress and loneliness increased two months into the COVID-19 pandemic-related shutdown. Factors associated with increased stress and/or loneliness included higher body mass index, social distancing, alcohol intake, and working from home. The authors concluded that ongoing attention to psychosocial well-being among individuals with obesity remains imperative both during the ongoing pandemic and afterwards.
AHRQ-funded; HS013852.
Citation: Borgatti AC, Crockett KB, Jacob AE .
Correlates of psychological distress among adults with obesity during the COVID-19 pandemic.
Psychol Health 2022 Dec; 37(12):1547-64. doi: 10.1080/08870446.2022.2038790..
Keywords: COVID-19, Obesity, Stress, Social Stigma, Behavioral Health
Rosen A, Carter D, Applebaum JR
Critical care clinicians' experiences of patient safety during the COVID-19 pandemic.
The purpose of this mixed methods, multi-institutional study was to explore how the COVID-19 pandemic worsened preexisting issues of patient safety and created new challenges for patient safety within United States intensive care units (ICU.) The researchers conducted a national survey of critical care clinicians to assess their experiences related to patient safety during the pandemic. The survey instrument was distributed via email through the Society of Critical Care Medicine listserv, with results reported as percentages while free-text responses were analyzed and coded for themes. The study found that of the 355 survey responses received, 61% believed that conditions during the pandemic were more hazardous when compared with the period prior to the pandemic. When compared with providers who cared for mostly non-COVID-19 or no COVID-19 patients, the professionals who cared for primarily COVID-19 patients had an increased likelihood of perceiving that care was more hazardous. In the coded free-text responses, providers identified themes in patient safety risks including ventilator-related lung injury, medication and diagnostic errors, oversedation, oxygen device removal, and falls. The study concluded that higher levels of COVID-19 case burden were significantly related with perceptions of a less safe patient care environment by frontline ICU clinicians, and further identified specific hazards in intensive care units.
AHRQ-funded; HS026121.
Citation: Rosen A, Carter D, Applebaum JR .
Critical care clinicians' experiences of patient safety during the COVID-19 pandemic.
J Patient Saf 2022 Dec 1;18(8):e1219-e25. doi: 10.1097/pts.0000000000001060..
Keywords: COVID-19, Patient Safety, Critical Care, Intensive Care Unit (ICU)
Bergman ZR, Tignanelli CJ, Gould R
Factors associated with mortality in patients with COVID-19 receiving prolonged ventilatory support.
This study examined outcomes for COVID-19 patients who required mechanical ventilation from March 2020 through December 2021 across a system of 11 hospitals. A cohort of 600 patients were included, with in-hospital mortality of 40.3%. Increased age, prolonged ventilation, receiving corticosteroids, and being non-English speaking were associated with mortality. Intubations lasting longer than 21 days had a lower in-hospital mortality of 25.7%.
AHRQ-funded; HS026379.
Citation: Bergman ZR, Tignanelli CJ, Gould R .
Factors associated with mortality in patients with COVID-19 receiving prolonged ventilatory support.
Surg Infect 2022 Dec;23(10):893-901. doi: 10.1089/sur.2022.195..
Keywords: COVID-19, Mortality, Respiratory Conditions