Becker's Clinical Quality & Infection Control

38 QUALITY IMPROVEMENT & MEASUREMENT Top 10 states for critical access hospital performance, ranked by HRSA By Alia Paavola T he federal Health Resources & Services Administration ranked Virginia the best state in the U.S. for the performance and reporting quality of its critical access hospitals. Every year, the HHS agency re- sponsible for improving healthcare access for the uninsured, isolated and medically vulnerable recogniz- es the 10 top states with the highest reporting rates and improvement for critical access hospitals in the last year. The list is part of the agency's Medi- care Beneficiary Quality Improve- ment Project. Through the project, the agency works with more than 1,350 critical access hospitals in 45 states to report quality measures. Critical access hospitals report data in patient safety, outpatient care, patient engagement and care tran- sitions. The performance outcomes and quality reporting in those areas determine the list. The top 10 states for 2020: 1. Virginia 2. South Carolina 3. Wisconsin 4. Idaho 5. Michigan 6. Georgia 7. Nebraska 8. Massachusetts 9. Illinois 10. Utah n Pandemic has varying effects on antibiotic use, studies show By Mackenzie Bean T rends in antibiotic use during the COVID-19 pandemic have varied across the nation, two studies found. Researchers from the University of Michigan in Ann Arbor led the first study, which was published in Clinical Infectious Diseases. Researchers reviewed data about 1,705 COVID-19 patients treated at 38 Michigan hospitals between March 13 and June 18. Nearly 57 percent of patients were prescribed early an- tibiotics, though 5 percent or less of patients had a bacterial infection. In some hospitals, early antibiotic use in COVID-19 patients was as high as 84 percent. A second study published in Antimicrobial Agents and Chemotherapy found monthly antibiotic use at the Veterans Affairs Pittsburgh Healthcare System dropped between March and June. Days of antibiotic therapy fell 6.5 percent monthly compared to a year prior due to the pause on elective surgeries and other nonessential procedures during the pandemic, according to researchers from the health system, the University of Pittsburgh and the Johns Hopkins Center for Health Security in Baltimore. Past research has suggested that the pandemic is boosting unnecessary antibiotic prescribing. However, these findings suggest that the pandemic has influenced antibiotic use in different ways, reported the University of Minneso- ta's Center for Infectious Disease Research and Policy in Minneapolis. Health experts said it could take several years to fully understand how COVID-19 will affect antibiotic resistance. n Racial inequities in US could be as deadly as COVID-19 By Morgan Haefner W hite Americans still have better mortality rates and life expectancy during the pandemic than Black Americans do during years without a global health crisis, according new research cited by NPR. e research, published in the Proceedings of the National Academy of Sciences, examines U.S. mortality data since 1900. Study author Elizabeth Wrigley-Field, PhD, found that in 2020, 700,000 to 1 million more white Americans would have to die for it to mirror the best year for life expectancy for Black Americans. e best mortality year for Black Americans was 2014, when average life expectancy was 75.3 years, according to NPR. White Americans had that life expectancy in 1989. "For COVID-19 to raise mortality as much as racial inequality does, it would need to erase two to three decades of mortality progress for whites," Dr. Wrigley-Field wrote in her analysis. Racial disparities in the U.S. affect every aspect of life, including healthcare. Amid the COVID-19 pandemic, individuals of color have been disproportionately affected by the virus. Some long-standing reasons why racial disparities persist in healthcare include poor access to care, historically racist housing policies and higher rates of underlying medical conditions, according to NPR. n

• Cover