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
101 to 125 of 322 Research Studies DisplayedLobach DF, Boxwala A, Kashyap N
AHRQ Author: Lomotan EA, Harrison MI, Dymek C, Swiger J
Integrating a patient engagement app into an electronic health record-enabled workflow using interoperability standards.
The authors sought to use interoperability standards to integrate the COVID-19 Tracker, a patient mobile application, with an EHR. Their clinical decision support integration project benefited from a standards-based approach, but they encountered challenges due to issues concerning implementation and experience of the standards-based application programming interface, Health Level 7 Fast Healthcare Interoperability Resources (FHIR) in the EHR. The authors concluded that FHIR standards may provide a promising mechanism for overcoming barriers in the integration of patient engagement apps with EHRs, but that expansion of available FHIR resources will improve workflow integration.
AHRQ-authored; AHRQ-funded; 233201500023I.
Citation: Lobach DF, Boxwala A, Kashyap N .
Integrating a patient engagement app into an electronic health record-enabled workflow using interoperability standards.
Appl Clin Inform 2022 Oct;13(5):1163-71. doi: 10.1055/s-0042-1758736..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Patient and Family Engagement, Workflow, COVID-19
Richmond J, Sanderson M, Shrubsole MJ
Psychosocial impact of COVID-19 among adults in the southeastern United States.
The authors investigated factors associated with depressive and anxiety symptoms during the COVID-19 pandemic. Using data from the Southern Community Cohort Study (SCCS), their results overall suggested that individuals in fair/poor health, living alone, and/or experiencing decreased physical activity and vegetable/fruit consumption have higher risk of depressive and anxiety symptoms. They recommended clinical and public health interventions to support individuals experiencing depression and anxiety during the COVID-19 pandemic.
AHRQ-funded; HS026122.
Citation: Richmond J, Sanderson M, Shrubsole MJ .
Psychosocial impact of COVID-19 among adults in the southeastern United States.
Prev Med 2022 Oct;163:107191. doi: 10.1016/j.ypmed.2022.107191..
Keywords: COVID-19, Anxiety, Depression, Behavioral Health, Public Health
Redwood R, Schulz LT, Pop-Vicas A
A perfect storm: COVID-19 and antimicrobial resistance.
The purpose of this article was to discuss key factors that contributed to the impact of the COVID-19 pandemic on antimicrobial resistance (AMR) with an emphasis on lessons learned and next steps. The authors report that the pandemic strained healthcare systems worldwide and disrupted standard infection control and antimicrobial stewardship practices, which are essential to limit the spread of multidrug-resistant organisms and decrease selective pressure related to inappropriate or unnecessary antimicrobial therapy. Disruptions to these practices are compounded by the disproportionately long hospital and intensive care unit stays observed in critically ill COVID-19 patients, leading to secondary bacterial infections that are notoriously difficult to treat and increase the use of broad-spectrum antibiotics, which can drive resistance. The article further states that the pandemic has led to shortages in personal protective equipment, increased workload, and staffing issues, all of which have disrupted routine antimicrobial stewardship activities. The article concludes that COVID-19 pandemic has highlighted the need to develop new therapeutic interventions for infectious diseases that do not rely solely on antibiotics, and stresses the importance of incorporating the lessons learned from the COVID-19 pandemic into future efforts to combat AMR.
AHRQ-funded; HS028669.
Citation: Redwood R, Schulz LT, Pop-Vicas A .
A perfect storm: COVID-19 and antimicrobial resistance.
EMJ, Microbiol Infect Dis 2022 Sep; 2022. doi: 10.33590/emjmicrobiolinfectdis/22-00082..
Keywords: COVID-19, Antimicrobial Stewardship, Antibiotics, Medication
Griffith 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
Shankar LG, Habich M, Rosenman M
Mental health emergency department visits by children before and during the COVID-19 pandemic.
Investigators described pediatric mental health emergency department (ED) visit rates and visit characteristics before and during the COVID-19 pandemic. They found that mental health ED visit rates by children increased during the COVID-19 pandemic.
AHRQ-funded; HS026385.
Citation: Shankar LG, Habich M, Rosenman M .
Mental health emergency department visits by children before and during the COVID-19 pandemic.
Acad Pediatr 2022 Sep-Oct;22(7):1127-32. doi: 10.1016/j.acap.2022.05.022..
Keywords: COVID-19, Children/Adolescents, Emergency Department, Behavioral Health, Healthcare Utilization, Public Health
Beetham T, Fiellin DA, Busch SH
Physician response to COVID-19-driven telehealth flexibility for opioid use disorder.
This study surveyed physicians who provide opioid use disorder (OUD) treatment on their preferences and practices regarding telehealth that have evolved during the COVID-19 pandemic. A total of 1141 physicians who were publicly listed buprenorphine-prescribing physicians were surveyed. Most respondents found telehealth to be effective, with 54% who found it more effective than expected. Overall, 85% were in favor of temporary telehealth flexibility being permanently extended, and 77% would be likely to use telehealth after the COVID-19 pandemic is over.
AHRQ-funded; HS017589.
Citation: Beetham T, Fiellin DA, Busch SH .
Physician response to COVID-19-driven telehealth flexibility for opioid use disorder.
Am J Manag Care 2022 Sep;28(9):456-63. doi: 10.37765/ajmc.2022.89221..
Keywords: COVID-19, Telehealth, Health Information Technology (HIT), Opioids, Substance Abuse, Behavioral Health, Medication
Dikranian L, Barry S, Ata A
Sars-CoV-2 with concurrent respiratory viral infection as a risk factor for a higher level of care in hospitalized pediatric patients.
This study’s objective was to evaluate if the presence of concurrent respiratory viral infections in pediatric patients admitted to the hospital with SARS-CoV-2 was associated with an increased rate of ICU level of care. Data from 67 participating hospitals was provided through The Society of Critical Care Medicine Discovery Network Viral Infection and Respiratory Illness Universal Study database. A total of 922 patients were included, with 391 requiring ICU level care and 31 having concurrent non-SARS-CoV-2 viral coinfection. After accounting for age, positive blood culture, positive sputum culture, preexisting chronic medical conditions, the presence of a viral respiratory coinfection was associated with increased need for ICU care.
AHRQ-funded; HS026485.
Citation: Dikranian L, Barry S, Ata A .
Sars-CoV-2 with concurrent respiratory viral infection as a risk factor for a higher level of care in hospitalized pediatric patients.
Pediatr Emerg Care 2022 Sep;38(9):472-76. doi: 10.1097/pec.0000000000002814..
Keywords: COVID-19, Children/Adolescents, Respiratory Conditions, Risk
Adams C, Chamberlain A, Wang Y
The role of staff in transmission of SARS-CoV-2 in long-term care facilities.
The purpose of this study was to assess the role of long-term care facility (LTCF) staff in transmission of the SARS-CoV-2 virus. From March 2020 to September the researchers evaluated residents and staff of 60 LTCFs in Georgia. The study found that after vaccines were first distributed to LTCFs in December 202, case counts, outbreak size and duration, and time-varying reproduction number [R(t)] declined rapidly. Staff cases were six times more infectious than resident cases, and unvaccinated resident cases were more infectious than vaccinated resident cases. The researchers concluded that staff were the primary drivers of COVID-19 transmission in LTCFs and vaccines slowed the transmission of the virus and contributed to a reduction in cases in LTCFs.
AHRQ-funded; HS025987.
Citation: Adams C, Chamberlain A, Wang Y .
The role of staff in transmission of SARS-CoV-2 in long-term care facilities.
Epidemiology 2022 Sep 1;33(5):669-77. doi: 10.1097/ede.0000000000001510..
Keywords: COVID-19, Respiratory Conditions, Long-Term Care, Public Health
Jin DP, Samuel S, Bowden K
Just-in-time electronic health record retraining to support clinician redeployment during the COVID-19 surge.
The purpose of this study was to examine the use of training in ICU-specific electronic health record (EHR) workflows prior to redeployment of certified registered nurse anesthetists (CRNAs) as ICU clinicians during the COVID-19 surge. The researchers utilized clinical informatics (CI) fellows to lead a multidisciplinary team to deploy a customized HER curriculum consisting of in-person classes and online video modules. Eighteen CRNAs participated, with 15 completing surveys immediately after the in-person training session, and 12 participants completing a post-deployment survey. The study found that all respondents of the post-training survey thought the training was useful and improved their EHR skills. Of the 12 participants who completed the post-deployment survey, all said that the training both increased their comfort in the ICU and that the concepts learned would be useful in their anesthesia role, and 91% indicated the training prepared them to work in the ICU with minimal guidance. The researchers concluded that CI fellows are uniquely prepared to deliver EHR training for clinician deployment in operational crisis response.
AHRQ-funded; HS02373.
Citation: Jin DP, Samuel S, Bowden K .
Just-in-time electronic health record retraining to support clinician redeployment during the COVID-19 surge.
Appl Clin Inform 2022 Aug 29;13(5):949-55. doi: 10.1055/a-1933-1798..
Keywords: COVID-19, Electronic Health Records (EHRs), Health Information Technology (HIT), Public Health, Training, Workforce
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
Guo W, Li Y, Temkin-Greener H
Coronavirus disease 2019 (COVID-19) in assisted living communities: neighborhood deprivation and state social distancing policies matter.
Investigators examined the association between COVID-19 cases in assisted living communities (ALCs) and the proportion of Medicare-Medicaid (dual) eligible minority residents, neighborhood area deprivation, and state COVID-19 policy stringency. They found that ALCs with higher proportions of dual-eligible minority residents were more likely to have COVID-19 outbreaks within their communities. Further, ALCs located in more socioeconomically deprived neighborhoods, and in states with less stringent state social distancing policies, tended to have more COVID-19 cases.
AHRQ-funded; HS026893.
Citation: Guo W, Li Y, Temkin-Greener H .
Coronavirus disease 2019 (COVID-19) in assisted living communities: neighborhood deprivation and state social distancing policies matter.
Infect Control Hosp Epidemiol 2022 Aug;43(8):1004-09. doi: 10.1017/ice.2022.46..
Keywords: COVID-19, Elderly, Long-Term Care, Policy, Public Health
Hails KA, Petts RA, Hostutler CA
COVID-19 distress, negative parenting, and child behavioral problems: the moderating role of parent adverse childhood experiences.
This study’s objective was to test a moderated mediation model to determine whether families’ COVID-19-related distress is associated with young children's emotional/behavioral functioning via negative parenting, and whether these relationships vary based on parents' adverse childhood experiences (ACEs). Participants were 267 parents recruited from five primary care sites across the United States with children ages 1.5-5 years. Internet questionnaires were completed on measures including demographics, parent ACEs, negative parenting, parent mental health, and COVID-19 distress. Negative parenting significantly mediated the relationship between COVID-19 distress and child emotional/behavioral problems. The model accounted for 42% variance in child emotional/behavioral problems.
AHRQ-funded; HS022981.
Citation: Hails KA, Petts RA, Hostutler CA .
COVID-19 distress, negative parenting, and child behavioral problems: the moderating role of parent adverse childhood experiences.
Child Abuse Negl 2022 Aug;130(Pt 1):105450. doi: 10.1016/j.chiabu.2021.105450..
Keywords: Children/Adolescents, COVID-19, Behavioral Health, Stress
Adams C, Wortley P, Chamberlain A
Declining COVID-19 case-fatality in Georgia, USA, March 2020 to March 2021: a sign of real improvement or a broadening epidemic?
This article examined whether declines in the crude US COVID-19 case fatality ratio is due to improved clinical care and/or other factors. The authors used multivariable logistic regression to examine associations between report month and mortality among confirmed and probable COVID-19 cases and hospitalized cases in Georgia from March 2020 through March 2021. Mortality risk was lowest in November 2020 compared to August 2020 and remained lower until March 2021. Among hospitalized cases, mortality risk increased in December 2020 and January 2021 before declining in March 2021. The authors concluded that improved clinical management may have contributed to lower mortality risk.
AHRQ-funded; HS025987.
Citation: Adams C, Wortley P, Chamberlain A .
Declining COVID-19 case-fatality in Georgia, USA, March 2020 to March 2021: a sign of real improvement or a broadening epidemic?
Ann Epidemiol 2022 Aug;72:57-64. doi: 10.1016/j.annepidem.2022.05.008..
Keywords: COVID-19, Public Health, Mortality
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
Hinson JS, Klein E, Smith A
Multisite implementation of a workflow-integrated machine learning system to optimize COVID-19 hospital admission decisions.
This study’s objective was to develop, implement, and evaluate an electronic health record (EHR) embedded clinical decision support (CDS) system that leveraged machine learning (ML) to estimate short-term risk for clinical deterioration in patients with or under investigation for COVID-19. The system translates model-generated risk for critical care needs within 24 hours and inpatient care needs within 72 hours into rapidly interpretable COVID-19 Deterioration Risk Levels made viewable within ED clinician workflow. A retrospective cohort of 21,452 ED patients who visited one of five ED study sites was used to derive ML models and were prospectively validated in 15,670 ED visits that occurred before (n = 4322) or after (n = 11,348) CDS implementation. Model performance and numerous patient-oriented outcomes including in-hospital mortality were measured across study periods. ML model performance was excellent under all conditions. AUC ranged from 0.85 to 0.91 for prediction of critical care needs and 0.80-0.90 for inpatient care needs. Total mortality was unchanged across study periods but was reduced among high-risk patients after the implementation.
AHRQ-funded; HS026640.
Citation: Hinson JS, Klein E, Smith A .
Multisite implementation of a workflow-integrated machine learning system to optimize COVID-19 hospital admission decisions.
NPJ Digit Med 2022 Jul 16;5(1):94. doi: 10.1038/s41746-022-00646-1..
Keywords: COVID-19, Clinical Decision Support (CDS), Health Information Technology (HIT), Implementation, Electronic Health Records (EHRs), Emergency Department, Shared Decision Making
Shao CC, McLeod MC, Gleason LT
Inequity in telemedicine use among patients with cancer in the Deep South during the COVID-19 pandemic.
The authors’ goal was to characterize telemedicine use among a large oncology population in the Deep South during the COVID-19 pandemic. They found that telemedicine use, specifically with video, was significantly lower among historically vulnerable populations. They concluded that understanding barriers to telemedicine use and preferred modalities of communication among different populations will help inform insurance reimbursement and interventions at different socioecological levels to ensure that the continued evolution of telemedicine will be equitable.
AHRQ-funded; HS013852.
Citation: Shao CC, McLeod MC, Gleason LT .
Inequity in telemedicine use among patients with cancer in the Deep South during the COVID-19 pandemic.
https://www.pubmed.ncbi.nlm.nih.gov/35348793
Oncologist 2022 Jul 5;27(7):555-64. doi: 10.1093/oncolo/oyac046..
Oncologist 2022 Jul 5;27(7):555-64. doi: 10.1093/oncolo/oyac046..
Keywords: COVID-19, Telehealth, Health Information Technology (HIT), Cancer, Disparities
Keller SC, Caballero TM, Tamma PD
AHRQ Author: Miller MA
Assessment of changes in visits and antibiotic prescribing during the Agency for Healthcare Research and Quality Safety Program for Improving Antibiotic Use and the COVID-19 pandemic.
This cohort study evaluated the effectiveness of the AHRQ Safety Program for Improving Antibiotic Use aimed to improve antibiotic prescribing in ambulatory practices by engaging clinicians and staff to incorporate antibiotic stewardship into practice culture, communication, and decision-making. The study ran from December 2019 through November 2020. A total of 389 ambulatory care practices with over 6.5 million visits to 5483 clinicians were compared from the baseline to completion of the program. Participants included 82 primary care practices, 103 urgent care practices, 34 federally supported practices, 21 pediatric-only practices, 39 pediatric urgent care practices, 21 pediatric-only practices, and 14 other practice types. Of the 389 practices who completed the program, 75% submitted completed data. Visits per practice per month decreased from a mean of 1624 at baseline to a nadir of 906 early in the COVID-19 pandemic (April 2020) and were 1797 at the end of the program. Total antibiotic prescribing decreased from 18.2% of visits at baseline to 9.5% at completion of the program. Acute respiratory infection (ARI) visits per practice per month decreased from a baseline of 321 to a nadir of 76 early in the pandemic (May 2020) and gradually increased through completion of the program (n = 239). Antibiotic prescribing for ARIs decreased from 39.2% at baseline to 24.7% at completion of the program.
AHRQ-authored; AHRQ-funded; 233201500020I.
Citation: Keller SC, Caballero TM, Tamma PD .
Assessment of changes in visits and antibiotic prescribing during the Agency for Healthcare Research and Quality Safety Program for Improving Antibiotic Use and the COVID-19 pandemic.
JAMA Netw Open 2022 Jul;5(7):e2220512. doi: 10.1001/jamanetworkopen.2022.20512..
Keywords: Antimicrobial Stewardship, Antibiotics, Medication, COVID-19, Public Health, Respiratory Conditions
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
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
Ward MJ, Shuster JL, Mohr NM
Implementation of telehealth for psychiatric care in VA emergency departments and urgent care clinics.
The purpose of this AHRQ-funded, mixed-methods study was to evaluate an emergency telehealth intervention in emergency department (ED) and urgent care clinic (UCC) settings within the Veterans Health Administration (VHA) in March 2020. The Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework was utilized to compare the 3 months preimplementation of the telehealth intervention (December 1, 2019 through February 29, 2020) with the 3 months postimplementation of the telehealth intervention (April 1, 2020 through June 30, 2020), and then assess sustainability through January 31, 2021. Qualitative data from surveys and semistructured interviews were conducted and analyze. The telemental health intervention was used in 83% (319) of unscheduled mental health consultations in the postimplementation phase, with no adverse trends in length of stay, 7-day revisits, or 30-day mortality. In the sustainability phase, use of the intervention was high with 82% (n = 1,010) of all unscheduled mental health consultations performed by telemental health. The study concluded that the use of unscheduled telemental health intervention was highly acceptable and sustainable in ED and UCC settings and did not impact the safety and efficacy of mental health consultations.
AHRQ-funded; HS025753.
Citation: Ward MJ, Shuster JL, Mohr NM .
Implementation of telehealth for psychiatric care in VA emergency departments and urgent care clinics.
Telemed J E Health 2022 Jul;28(7):985-93. doi: 10.1089/tmj.2021.0263..
Keywords: COVID-19, Telehealth, Health Information Technology (HIT), Behavioral Health, Emergency Department
Sun J, Peng L, Li T
Performance of a chest radiograph AI diagnostic tool for COVID-19: a prospective observational study.
The purpose of this observational study was to evaluate the real-time performance of an interpretable artificial intelligence (AI) model to detect COVID-19 on chest radiographs. The researchers utilized 95,363 chest radiographs for model training, external validation, and real-time validation. There were 5,335 real-time predictions and a COVID-19 prevalence of 4.8%. The study found that participants positive for COVID-19 had higher COVID-19 diagnostic scores than participants negative for COVID-19. Real-time model performance remained the same during the 19 weeks of implementation. Model sensitivity was higher in men than in women, but model specificity was higher in women. Sensitivity was higher for Asian and Black participants compared with White participants. The COVID-19 AI diagnostic system had worse accuracy compared with radiologist predictions. The researchers concluded that AI tools underperform when compared with radiologist results.
AHRQ-funded; HS026379.
Citation: Sun J, Peng L, Li T .
Performance of a chest radiograph AI diagnostic tool for COVID-19: a prospective observational study.
Radiol Artif Intell 2022 Jul;4(4):e210217. doi: 10.1148/ryai.210217..
Keywords: COVID-19, Imaging, Diagnostic Safety and Quality, Health Information Technology (HIT)
Banerji A, Norton AE, Blumenthal KG
Rapid progress in our understanding of COVID-19 vaccine allergy: a cause for optimism, not hesitancy.
This paper is a review of current understanding of COVID-19 vaccine allergy. Rapid progress has been made over the past several years in large part due to important research efforts from individuals in the allergy community. Better data has shown safety of repeat vaccination despite an initial reaction. The review ran from December 2020 through early 2022.
AHRQ-funded; HS026395; HS025375
Citation: Banerji A, Norton AE, Blumenthal KG .
Rapid progress in our understanding of COVID-19 vaccine allergy: a cause for optimism, not hesitancy.
J Allergy Clin Immunol 2022 Jul;150(1):12-16. doi: 10.1016/j.jaci.2022.03.023..
Keywords: COVID-19, Vaccination, Adverse Drug Events (ADE), Adverse Events
Zeng W, Jarawan E, Bajnauth D
AHRQ Author: Ding Y
COVID-19 and global mental health service delivery and financing.
The purpose of this AHRQ-authored letter was to characterize the state of global mental health needs, service delivery, and financing as a result of the COVID-19 pandemic. The authors report that the mental health aftermath of the COVID-19 pandemic will likely be extended in duration and will both compound and deepen the social and economic disruptions that were already taking place prior to the pandemic. The authors conclude that the integration of mental health initiatives into both international and national emergency response strategies and public health strategies is important as governments enhance mental health service delivery and financing as a critical component of building more inclusive and resilient postpandemic health systems.
AHRQ-authored.
Citation: Zeng W, Jarawan E, Bajnauth D .
COVID-19 and global mental health service delivery and financing.
Public Health 2022 Jun;207:127-28. doi: 10.1016/j.puhe.2022.04.005..
Keywords: COVID-19, Healthcare Delivery, Behavioral Health
Semere W, Makaroun LK, Beach S
Family caregivers navigating the health care system: evolving roles during the COVID-19 pandemic.
The purpose of this study was to explore changes in the ways family caregivers assisted family members with chronic illness and disability in addressing their health care needs during the COVID-19 pandemic. The researchers administered telephone and online surveys to family caregivers who were listed in a regional research registry, asking them what level of helping they provided during the pandemic compared to the level they were providing prior to the pandemic. The study found that of the 561caregivers that responded to the survey, 59% reported an increase in providing help with 1 or more heath care activities. The researchers advise that for caregivers assisting vulnerable patients to access care, support strategies should be considered by the health system and health care providers.
AHRQ-funded; HS027844.
Citation: Semere W, Makaroun LK, Beach S .
Family caregivers navigating the health care system: evolving roles during the COVID-19 pandemic.
Fam Syst Health 2022 Jun;40(2):268-73. doi: 10.1037/fsh0000688..
Keywords: Caregiving, COVID-19, Chronic Conditions