Research Roundup: Global Health Systems; Rural Hospitals; And Early Intervention In Palliative Care

Commonwealth Fund: 2020 International Profiles: Country Responses COVID-19 Pandemic
For a decade, the Commonwealth Fund and the London School of Economics and Political Science have collaborated to produce the International Profiles of Health Care Systems that show how health systems across the world are organized. The 2020 profiles — released last week — feature 20 countries across North and South America, Europe, Asia, and Australasia. While the profiles do not directly address pandemic preparedness, they do offer context for understanding how countries have responded to COVID-19. The profiles describe how decisions regarding health care and public health are made — including for infectious-disease control — at the national, regional, and local levels. This can help readers understand why some countries have been better positioned to monitor and limit the spread of the virus. (Tikkanen et al, 6/10)

Health Affairs: Varying Trends In The Financial Viability Of US Rural Hospitals, 2011–17
The financial viability of rural hospitals has been a matter of serious concern, with ongoing closures affecting rural residents’ access to medical services. We examined the financial viability of 1,004 US rural hospitals that had consistent rural status in 2011–17. The median overall profit margin improved for nonprofit critical access hospitals (from 2.5 percent to 3.2 percent) but declined for other hospitals (from 3.0 percent to 2.6 percent for nonprofit non–critical access hospitals, from 3.2 percent to 0.4 percent for for-profit critical access hospitals, and from 5.7 percent to 1.6 percent for for-profit non–critical access hospitals). (Bai et al, 6/3)

JAMA Internal Medicine: Early Intervention Of Palliative Care In The Emergency Department During The COVID-19 Pandemic
During the novel coronavirus disease 2019 (COVID-19) pandemic, it is particularly critical to ensure that life-sustaining treatment (LST) such as intubation and resource-intensive cardiopulmonary resuscitation (CPR) are aligned with a patient’s goals and values, and to avoid LSTs in patients with a poor prognosis that are unlikely to be beneficial, but have a high risk of causing additional suffering. (Lee et al, 6/5)

Urban Institute: How Cities Are Leveraging Technology To Meet Residents’ Needs During A Pandemic
Amid stay-at-home orders and other tactics to stem the spread of COVID-19, millions of Americans’ daily lives have shifted online. Many employees work from home, students take online classes, and city officials rely on livestreams and social media to disseminate information. But the sudden shift to an online-based life has highlighted the inequity of access to reliable technology for many US households. To understand how city officials are addressing technology equity gaps to meet their residents’ needs, the Urban Institute surveyed Chief Technology Officers, Chief Information Officers, Chief Innovation Officers, and Digital Inclusion Leads in cities across the country. (Brown, Ezike and Stern, 6/9)

Health Affairs: Incarceration And Its Disseminations: COVID-19 Pandemic Lessons From Chicago’s Cook County Jail
Jails and prisons are major sites of novel coronavirus (SARS-CoV-2) infection. Many jurisdictions in the United States have therefore accelerated release of low-risk offenders. Early release, however, does not address how arrest and pre-trial detention practices may be contributing to disease spread. Using data from Cook County Jail, in Chicago, Illinois, one of the largest known nodes of SARS-CoV-2 spread, we analyze the relationship between jailing practices and community infections at the zip-code level. We find that jail cycling is a significant predictor of SARS-CoV-2 infection, accounting for 55 percent of the variance in case rates across zip codes in Chicago and 37 percent in Illinois. (Reinhart and Chen, 6/4)

CIDRAP: Single-Dose Baloxavir Works As Well As 5 Days Of Tamiflu For Flu, Study Finds
A phase 3 trial of Shionogi's baloxavir marboxil (Xofluza) has found that a single dose of the antiviral flu drug was superior to placebo and similar to oseltamivir (Tamiflu) in shortening the duration of illness in adult and adolescent outpatients at high risk for flu-related complications. The study, published yesterday in The Lancet Infectious Diseases, also showed that baloxavir stopped viral shedding sooner and caused fewer adverse events, such as sinusitis, bronchitis, and nausea, than placebo, mostly in those receiving treatment within 36 hours of symptom onset. (Van Beusekom, 6/9)