AJPM focus最新文献

{"title":"Costs and Healthcare Utilization of Heart Disease by COVID-19 Diagnosis and Race and Ethnicity","authors":"Jun Soo Lee PhD ,&nbsp;Yidan (Xue) Zhang PhD, MC ,&nbsp;Lisa M. Pollack PhD, MPH, MPT ,&nbsp;Feijun Luo PhD","doi":"10.1016/j.focus.2024.100285","DOIUrl":"10.1016/j.focus.2024.100285","url":null,"abstract":"<div><h3>Introduction</h3><div>Heart disease poses a significant health and economic burden in the U.S., with considerable variations in outcomes across different racial and ethnic groups. The COVID-19 pandemic has further highlighted the disparities in healthcare utilization and costs associated with heart disease.</div></div><div><h3>Methods</h3><div>The authors used the 2021 Merative MarketScan Medicaid claims database to estimate the medical costs and healthcare utilization associated with heart disease by racial and ethnic groups and COVID-19 diagnosis status. This study focused on individuals aged ≥18 years continuously enrolled in a noncapitated insurance plan in 2021. The outcome measures included total medical expenditures and healthcare utilization, including the numbers of emergency department visits and inpatient admissions and length of inpatient stay. The authors employed a generalized linear model with a family of gamma and log links for medical costs, and a negative binomial regression was used for healthcare utilization. Three-way interactions of heart disease, COVID-19 diagnosis, and race and ethnicity categories were implemented after adjusting for age, sex, and comorbidities. The authors reported average marginal effects with 95% CIs.</div></div><div><h3>Results</h3><div>Among 1,008,166 Medicaid beneficiaries, 8% had heart disease in 2021. The cost associated with heart disease was $10,819 per beneficiary in 2021 (95% CI=10,292; 11,347; <em>p</em>&lt;0.001). The cost was $15,840 (95% CI=14,389; 17,291; <em>p</em>&lt;0.001) for non-Hispanic Black individuals; $9,945 (95% CI=9,172; 10,718; <em>p</em>&lt;0.001) for non-Hispanic White; and $8,511 (95% CI=7,490; 9,531; <em>p</em>&lt;0.001) for Hispanic individuals. Individuals with a COVID-19 diagnosis ($19,638) had $9,541 (95% CI=7,049; 12,032; <em>p</em>&lt;0.001) higher costs associated with heart disease than those without COVID-19 ($10,098) (<em>p</em>&lt;0.001). Individuals with heart disease had higher numbers of emergency department visits (0.937 per beneficiary, 95% CI=0.913; 0.960), inpatient admissions (0.463 per beneficiary, 95% CI=0.455; 0.471), and average length of stay (2.541 days per admission, 95% CI=2.405; 2.677) than those without heart disease.</div></div><div><h3>Conclusions</h3><div>The study's findings showed that costs and healthcare utilization associated with heart disease are substantial in all racial and ethnic groups and the highest among non-Hispanic Black individuals. Furthermore, individuals with a COVID-19 diagnosis had approximately 2 times higher costs associated with heart disease than individuals without a COVID-19 diagnosis.</div></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"4 1","pages":"Article 100285"},"PeriodicalIF":0.0,"publicationDate":"2024-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142658498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Underutilization of National Diabetes Prevention Program Among Women With a History of Gestational Diabetes Mellitus: An In-Depth Focus Group Analysis","authors":"Priyadharshini Narayanan MD, MPH ,&nbsp;Sahitya R. Kothapalli MPH ,&nbsp;Harmonie B. Strohl MDc ,&nbsp;Linda L. Hill MD, MPH","doi":"10.1016/j.focus.2024.100279","DOIUrl":"10.1016/j.focus.2024.100279","url":null,"abstract":"<div><h3>Introduction</h3><div>Gestational diabetes mellitus significantly increases the risk of developing Type 2 diabetes mellitus in women. However, the National Diabetes Prevention Program, effective in reducing Type 2 diabetes mellitus incidence, is underutilized among women with a history of gestational diabetes mellitus. This study aims to explore the factors contributing to this underutilization and propose strategies to increase National Diabetes Prevention Program's usage.</div></div><div><h3>Methods</h3><div>A qualitative study with narrative methodology was employed, involving focus group discussions with 18 women aged between 29 and 43 years, who had a history of gestational diabetes mellitus. Participants were recruited from a gestational diabetes mellitus registry through University of California, San Diego's online platform. The discussions were aimed at understanding their awareness of Type 2 diabetes mellitus risk after gestational diabetes mellitus and their knowledge about the National Diabetes Prevention Program.</div></div><div><h3>Results</h3><div>Thematic analysis of the discussions revealed 4 key themes: (1) challenges in navigating health information after gestational diabetes mellitus; (2) perceived facilitators for National Diabetes Prevention Program participation, including peer support, personalized guidance, and virtual options; (3) perceived barriers, such as time constraints, childcare responsibilities, and financial considerations; and (4) insights into patient perspectives on gestational diabetes mellitus care. Despite awareness of their increased Type 2 diabetes mellitus risk, there was a notable gap in knowledge about the National Diabetes Prevention Program among participants.</div></div><div><h3>Conclusions</h3><div>The study highlights the critical need for improved communication regarding postgestational diabetes mellitus risk of type 2 diabetes and the National Diabetes Prevention Program. Addressing communication gaps, offering personalized support, and accommodating the unique challenges faced by women with a history of gestational diabetes mellitus can enhance National Diabetes Prevention Program participation. The significance of a patient-centric approach in diabetes prevention is underscored, emphasizing that such an approach could significantly impact Type 2 diabetes mellitus prevention in this high-risk population.</div></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"4 1","pages":"Article 100279"},"PeriodicalIF":0.0,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142658500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ethnic and Racial Disparities in Self-Reported Personal Protective Equipment Shortages Among New York Healthcare Workers During the COVID-19 Pandemic","authors":"Armaan Sodhi MPH ,&nbsp;Stanford Chihuri MPH ,&nbsp;Christina W. Hoven DrPH, MPH ,&nbsp;Ezra S. Susser MD, DrPH ,&nbsp;Charles DiMaggio PhD ,&nbsp;David Abramson PhD ,&nbsp;Howard F. Andrews PhD ,&nbsp;Megan Ryan MS ,&nbsp;Guohua Li MD, DrPH","doi":"10.1016/j.focus.2024.100278","DOIUrl":"10.1016/j.focus.2024.100278","url":null,"abstract":"<div><h3>Introduction</h3><div>To assess the association of race and ethnicity with self-reported personal protective equipment shortages during the COVID-19 pandemic among healthcare workers in New York.</div></div><div><h3>Methods</h3><div>The COVID-19 Healthcare Personnel Study of New York was a prospective cohort study of HCWs with baseline data collected in April 2020 and follow-up data collected in February 2021. Multivariable logistic regression modeling was used to estimate the adjusted OR and 95% CIs of personal protective equipment shortages associated with race and ethnic minority status.</div></div><div><h3>Results</h3><div>Healthcare workers of racial and ethnic minority status (n=361) were more likely than non-Hispanic White respondents (n=1,858) to report having experienced personal protective equipment shortages in the last week at baseline (36.0% vs 27.5%; <em>p</em>=0.001) and follow-up (13.6% vs 8.8%; <em>p</em>=0.005). With adjustment for demographic and clinical characteristics, racial and ethnic minority status was associated with 44% and 49% increased odds of experiencing PPE shortages at baseline (adjusted OR=1.44; 95% CI=1.10, 1.88) and follow up (adjusted OR=1.49; 95% CI=1.01, 2.21), respectively.</div></div><div><h3>Conclusions</h3><div>Healthcare workers of racial and ethnic minority status in New York experienced more pervasive personal protective equipment shortages than their non-Hispanic White counterparts during the COVID-19 pandemic.</div></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"3 6","pages":"Article 100278"},"PeriodicalIF":0.0,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142572192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comprehensive Health Assessment Using Risk Prediction for Multiple Diseases Based on Health Checkup Data","authors":"Kosuke Yasuda PhD ,&nbsp;Shiori Tomoda MS ,&nbsp;Mayumi Suzuki MD, PhD ,&nbsp;Toshikazu Wada MD, PhD ,&nbsp;Toshiyuki Fujikawa ,&nbsp;Toru Kikutsuji MD, PhD ,&nbsp;Shintaro Kato PhD","doi":"10.1016/j.focus.2024.100277","DOIUrl":"10.1016/j.focus.2024.100277","url":null,"abstract":"<div><h3>Introduction</h3><div>Tools developed to assess individuals’ comprehensive health status would be beneficial for personalized prevention and treatment. This study aimed to develop a set of risk prediction models to estimate the risk for multiple diseases such as heart, blood vessel, brain, metabolic, liver, and kidney diseases using health checkup data only.</div></div><div><h3>Methods</h3><div>This is a retrospective study that used health checkup data combined with diagnostic information from electronic health records of Kurashiki Central Hospital in Okayama, Japan. All exposure factors were measured at the first health checkup visit, including demographic characteristics, laboratory test results, lifestyle questionnaires, medication use, and medical history. Primary outcomes were the diagnoses of 15 diseases during the follow-up period. Cox proportional hazard regression was applied to develop risk prediction models for heart, blood vessel, brain, metabolic, liver, and kidney diseases. Area under the curve with 4-year risk assessments were performed to evaluate the models.</div></div><div><h3>Results</h3><div>From January 2012 to September 2022, a total of 92,174 individuals aged 15–96 years underwent general health checkups. The area under the curve of the models in validation datasets was as follows: atrial fibrillation, 0.81; acute myocardial infarction, 0.81; heart failure, 0.76; cardiomyopathy, 0.72; angina pectoris, 0.70; atherosclerosis, 0.82; hypertension, 0.80; cerebral infarction, 0.77; intracerebral hemorrhage, 0.68; subarachnoid hemorrhage, 0.50; type-2 diabetes mellitus, 0.82; hyperlipidemia, 0.70; alcoholic liver disease, 0.91; liver fibrosis, 0.92; and chronic kidney disease, 0.80.</div></div><div><h3>Conclusions</h3><div>A set of prediction models to estimate multi-disease risk simultaneously from health checkup results may help to assess comprehensive individual health status and facilitate personalized prevention and early diagnosis.</div></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"3 6","pages":"Article 100277"},"PeriodicalIF":0.0,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142572191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Randomized Pilot of a Clinical Decision Support Tool to Increase Suicide Screening for at-Risk Primary Care Patients With Opioid Use Disorder","authors":"Rebecca C. Rossom MD ,&nbsp;A. Lauren Crain PhD ,&nbsp;Gavin Bart MD ,&nbsp;Julie E. Richards PhD ,&nbsp;Jennifer M. Boggs PhD ,&nbsp;Patrick J. O'Connor MD ,&nbsp;Caitlin Borgert-Spaniol MA ,&nbsp;Sheryl Kane MS ,&nbsp;Stephanie A. Hooker PhD","doi":"10.1016/j.focus.2024.100280","DOIUrl":"10.1016/j.focus.2024.100280","url":null,"abstract":"<div><h3>Introduction</h3><div>Individuals with opioid use disorder are at elevated suicide risk, but systematic screening in this population is rarely done. This study assessed the effects of targeted clinical decision support prompts on structured suicide risk assessment completion.</div></div><div><h3>Methods</h3><div>The study used a cluster-randomized controlled pragmatic pilot design. Adult primary care patients (aged 18–75 years) with or at risk for opioid use disorder or opioid overdose and suicide were eligible. Patients sought care from 15 Midwestern primary care clinics between July, 31, 2021 and July, 31, 2022. Data were analyzed between March and June 2023. Clinicians in intervention and control clinics received a printout from rooming staff, prompted by a clinical decision support-generated electronic health record alert, suggesting clinicians talk with patients about opioid risks. Intervention clinician handouts also alerted them to patients estimated to be at increased suicide risk and recommended completion of a Columbia Suicide Severity Rating Scale to further evaluate suicide risk. The handouts for control clinicians did not include suicide risk alerts. The main outcome measured the completion of the Columbia Suicide Severity Rating Scale in the 14 days following a visit.</div></div><div><h3>Results</h3><div>A total of 115 eligible patients (69 intervention, 46 control) made at least 1 visit to a randomized clinic. Patients mean age was 39 years, and 57% were women; 48% of patients had a high risk of opioid use disorder or opioid overdose, 39% had an opioid use disorder diagnosis, 12% had an opioid use disorder in remission diagnosis, and 5% had a recent opioid overdose. Over a mean follow-up of 249 days, 20.3% of intervention patients and 17.4% of control patients had at least 1 Columbia Suicide Severity Rating Scale completed in the next 14 days (<em>p</em>=0.70). Most (71%–75%) Columbia Suicide Severity Rating Scale scores were 0, indicating no risk.</div></div><div><h3>Conclusions</h3><div>This pilot study did not increase the uptake of structured suicide risk assessments in primary care for patients at elevated risk for opioid use disorder and suicide. More robust interventions are likely needed to promote suicide risk assessment in primary care.</div></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"3 6","pages":"Article 100280"},"PeriodicalIF":0.0,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142661922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial Board and Journal Information","authors":"","doi":"10.1016/j.focus.2024.100275","DOIUrl":"10.1016/j.focus.2024.100275","url":null,"abstract":"","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"3 5","pages":"Article 100275"},"PeriodicalIF":0.0,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773065424000932/pdfft?md5=88287f395684512e3d571c5a5846b644&pid=1-s2.0-S2773065424000932-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142315568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Work-Related Factors Associated With Psychological Distress Among Grocery Workers During the COVID-19 Pandemic","authors":"Julianne Payne PhD ,&nbsp;Nikie Sarris Esquivel MPH ,&nbsp;Karen Strazza MPH ,&nbsp;Catherine Viator MS ,&nbsp;Becky Durocher BA ,&nbsp;Jacqueline Sivén PhD ,&nbsp;Michael A. Flynn MA ,&nbsp;Cammie C. Menéndez PhD ,&nbsp;Harpriya Kaur PhD","doi":"10.1016/j.focus.2024.100272","DOIUrl":"10.1016/j.focus.2024.100272","url":null,"abstract":"<div><h3>Introduction</h3><div>During the COVID-19 pandemic, grocery workers experienced new (in addition to existing) work-related stressors that put them at risk for psychological distress. This study uses the job demands-resources theory to identify and describe the job demands and resources associated with grocery worker distress.</div></div><div><h3>Methods</h3><div>This study analyzed data from 75 90-minute interviews focusing on grocery workers’ experiences during the COVID-19 pandemic. During the interviews, participants also answered questions associated with the Patient Health Questionnaire 4, a validated measure of psychological distress.</div></div><div><h3>Results</h3><div>Overall, the study found that 36% of study participants exhibited mild to severe psychological distress at the time of their interviews, and a greater proportion of young, female, and White participants reported mild to severe psychological distress than did participants in other subgroups. Qualitative data suggest that the prevalence of psychological distress among participants was likely higher at the beginning of the pandemic and resulted from fear of SARS-CoV-2 exposure, conflict with customers, workplace discrimination, increased workload, and designation as an essential worker. Although about half of the participants in the sample said that their employers provided support to improve workers’ mental health, the interviews suggest that more could be done.</div></div><div><h3>Conclusions</h3><div>These findings may lead to opportunities to improve worker well-being during the COVID-19 pandemic and to prepare for future public health emergencies. Proposed strategies include implementing public health measures as advised by infectious disease experts; offering information and training; providing sick leave, long-term hazard pay, higher wages, and mental health benefits; and better distribution of workloads.</div></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"3 6","pages":"Article 100272"},"PeriodicalIF":0.0,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142327255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lifestyle Differences in the Metabolic Comorbidity Score of Adult Population From South Asian Countries: A Cross-Sectional Study","authors":"Sabera Sultana PhD ,&nbsp;Shuhei Nomura PhD ,&nbsp;Chris Fook Sheng NG, PhD ,&nbsp;Masahiro Hashizume PhD","doi":"10.1016/j.focus.2024.100273","DOIUrl":"10.1016/j.focus.2024.100273","url":null,"abstract":"<div><h3>Introduction</h3><div>Metabolic comorbidities are involved in the development and progression of noncommunicable diseases. There is convincing evidence that lifestyles are important contributors to metabolic comorbidities. This study measured the metabolic comorbidity score of South Asian adults and identified its relationship with lifestyles.</div></div><div><h3>Methods</h3><div>The authors studied 5 South Asian countries, including Afghanistan, Bangladesh, Bhutan, Nepal, and Sri Lanka, using the World Health Organization's STEPwise approach to noncommunicable disease risk factor surveillance data between 2014 and 2019. This was a nationally representative and cross-sectional survey on participants aged 15–69 years. The sample size was 27,616. The outcome was metabolic comorbidity score, calculated on the basis of total cholesterol, fasting plasma glucose, blood pressure, and abdominal obesity. Total metabolic comorbidity score of each participant varied between 0 and 8. It was then divided into 3 ranges: the lowest range (total metabolic comorbidity score &lt;3), medium range (total metabolic comorbidity score ≥3 and ≤5), and the highest range (total metabolic comorbidity score ≥6). On the basis of the outcome of nonparametric receiver operating characteristics analysis, the medium and the highest ranges together were considered as higher metabolic comorbidity score. The lowest range was considered as lower metabolic comorbidity score. The higher metabolic comorbidity score was coded as 1, and the lower metabolic comorbidity score was coded as 0. Thus, the outcome variable, metabolic comorbidity score, became a binary variable. Exposures included physical inactivity (&lt;150 minutes of medium-to-vigorous physical activity/week), high daily sedentary time (≥9 hours/day), use of tobacco (present or past smoking or daily use of smokeless tobacco products), and consumption of alcohol (at least once per month in the last 1 year). Binomial logistic regression model produced the OR with corresponding 95% CIs.</div></div><div><h3>Results</h3><div>The prevalence of higher metabolic comorbidity score was 34% among South Asian adults, 25% among the male respondents, and 41% among the female respondents. Participants who were physically inactive (OR=1.26; 95% CI= 1.17, 1.36), had high sedentary time (OR=1.24; 95% CI=1.11, 1.33), and consumed alcohol (OR=1.40; 95% CI=1.23, 1.53) showed higher metabolic comorbidity score than participants who were physically active, had low sedentary time, and did not consume alcohol respectively. However, the authors found an inverse association (OR=0.75; 95% CI=0.71, 0.81) between the use of tobacco and metabolic comorbidity score.</div></div><div><h3>Conclusions</h3><div>One third of South Asian adults had higher metabolic comorbidity score. Physical inactivity, daily sedentary hours, and minimal alcohol consumption were associated with higher metabolic comorbidity score.</div></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"3 6","pages":"Article 100273"},"PeriodicalIF":0.0,"publicationDate":"2024-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142319718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum: Associations of Historical Redlining With BMI and Waist Circumference in Coronary Artery Risk Development in Young Adults","authors":"","doi":"10.1016/j.focus.2024.100271","DOIUrl":"10.1016/j.focus.2024.100271","url":null,"abstract":"","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"3 5","pages":"Article 100271"},"PeriodicalIF":0.0,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773065424000890/pdfft?md5=dfeb2144e3c66ea5b35b3cebdacbb9f1&pid=1-s2.0-S2773065424000890-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142099103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The COVID-19 Pandemic's Effect on Preventive Imaging","authors":"Jenny L. Weon MD, PhD ,&nbsp;Yin Xi PhD ,&nbsp;Yee Seng Ng MD ,&nbsp;Lauren N. Cooper MS ,&nbsp;Marlon I. Diaz BS ,&nbsp;Robert W. Turer MD ,&nbsp;Samuel A. McDonald MD ,&nbsp;DuWayne L. Willett MD, MS ,&nbsp;Christoph U. Lehmann MD ,&nbsp;Ling Chu MD","doi":"10.1016/j.focus.2024.100270","DOIUrl":"10.1016/j.focus.2024.100270","url":null,"abstract":"<div><h3>Introduction</h3><div>This study assessed the effect of the COVID-19 pandemic on preventive care imaging and potential disparities because preventive care may be perceived as nonurgent. The objective was to identify the associations between the COVID-19 pandemic and changes in preventive imaging volumes for patients in general and as affected by race and ethnicities.</div></div><div><h3>Methods</h3><div>The authors performed a retrospective observational study by extracting the weekly volumes of all imaging studies between January 7, 2019 and May 1, 2022 from a radiology data warehouse at a tertiary care medical center (<em>n</em>=92,105 preventive imaging studies and 3,493,063 total radiology imaging studies) and compared preshutdown with postshutdown periods using a 2-sample <em>t</em>-test. Additional comparisons stratified by race and ethnicity were performed for mammograms and bone density examinations using interrupted time series models with negative binomial error distribution to assess the immediate level change and trends over time of preventive imaging volumes after shutdown.</div></div><div><h3>Results</h3><div>The authors found a significant decrease in bilateral mammograms, bone density examinations, and aortic ultrasound examinations in the postshutdown period compared with those in the preshutdown period (<em>p</em>&lt;0.001, <em>p</em>=0.003, and <em>p</em>=0.001, respectively). There were no significant changes in low-dose computed tomography chest examinations (<em>p</em>=0.46). The shutdown was associated with a significant immediate decrease in mammograms in the Hispanic and Latino group to approximately three quarters of its preshutdown level (<em>p</em>=0.04). For bone density examinations, postshutdown weekly volumes tripled compared with the preshutdown volumes for Hispanic or Latino patients and doubled for non-Hispanic Black patients (<em>p</em>&lt;0.0001 for both). In comparison, a significant decrease was seen for Other patients (reduced to nearly a fifth of preshutdown volume) (<em>p</em>&lt;0.0001).</div></div><div><h3>Conclusions</h3><div>There was a significant decrease in overall volume of bilateral mammograms, bone density examinations, and aortic ultrasound examinations after pandemic shutdown. For mammograms, some of this decreasing trend was already seen before shutdown (such as for patients with Other race), so the shutdown was only specifically associated with an immediate decrease in mammogram levels in the Hispanic and Latino group. For bone density examinations, the shutdown was unexpectedly associated with an increase in volumes for Hispanic or Latino patients and non-Hispanic Black patients, which was countered by a significant steep decrease in volumes only for patients of Other race. Health systems should carefully explore their preventive screening examination volumes to determine which patients should be actively engaged to assure catch up on recommended care.</div></div>","PeriodicalId":72142,"journal":{"name":"AJPM focus","volume":"3 6","pages":"Article 100270"},"PeriodicalIF":0.0,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142415920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}