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https://www.readbyqxmd.com/read/27913067/the-financial-impact-of-clinic-no-show-rates-in-an-academic-pediatric-otolaryngology-practice
#1
Zhen Huang, Mariam Ashraf, Heather Gordish-Dressman, Pamela Mudd
PURPOSE: To investigate determinants of no-show rates in an academic pediatric otolaryngology practice including appointment time, age, sex, new patient status, payer mix, and median household income by zip code. MATERIALS AND METHODS: Retrospective chart review of clinic no-show rates and patient demographics in a free standing children's hospital and affiliated outpatient clinics across eight providers in a one-year period. RESULTS: Analysis shows that the overall no-show rate across all providers was 15% with the highest rate of 19% in the zip code with the lowest median income...
November 23, 2016: American Journal of Otolaryngology
https://www.readbyqxmd.com/read/27893581/the-effect-of-socioeconomic-status-and-parental-demographics-on-activation-of-department-of-child-and-family-services-in-pediatric-burn-injury
#2
Jessica K Campos, Yee M Wong, Brittany N Hasty, Kelly A McElligott, Michael J Mosier
Burns resulting from child maltreatment are tragic causes of significant morbidity and mortality, most commonly affecting children under 3 years of age. More than one third of nonaccidental burns occur in single-parent homes or have parents with history of mental illness, substance abuse, incarceration, or Department of Children and Family Services (DCFS) involvement. The authors sought to profile pediatric burn injuries associated with DCFS investigations. They performed a retrospective chart review of pediatric burn patients, admitted between January 1, 2011 and December 31, 2014...
November 11, 2016: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/27885788/barriers-to-live-donor-kidney-transplants-in-the-pediatric-population-a-single-center-experience
#3
Shibany P Taormina, Matthew P Galloway, Amrish Jain
A decrease in live donor pediatric kidney transplants has occurred in the United States. This study investigates barriers that may influence access to live donor kidney transplants in children. Retrospective chart review was conducted for 91 children (69% male, mean age 11.9 years) who underwent pretransplant workup from 2005 to 2015 at an urban pediatric hospital. Fifty-four percent were African American, 32% Caucasian, 8% Arabic, 3% Hispanic, and 3% Others. Government-sponsored insurance (Medicaid/Medicare) was utilized by 73%, and 54% had dual caregivers...
November 25, 2016: Pediatric Transplantation
https://www.readbyqxmd.com/read/27866643/evaluating-levels-of-dentist-participation-in-medicaid-a-complicated-endeavor
#4
Clayton J Warder, Burton L Edelstein
BACKGROUND: The availability of dentists to care for Medicaid beneficiaries is a longstanding concern of many families and those who serve them in the dental profession as well as policy makers. Yet, little information beyond the number of enrolled dentists has been reliably determined. The American Dental Association (ADA) Health Policy Institute has called for more nuanced measures that better reflect dentistry's contribution to the care of Medicaid beneficiaries. METHODS: The authors calculated percentages of general and pediatric dentists who enrolled in Medicaid, billed Medicaid, and treated Medicaid beneficiaries in each state for which data were available from the ADA's 2008 study, the Association of State and Territorial Dental Directors' 2013 report, and the 2013 federal Web site InsureKidsNow...
November 17, 2016: Journal of the American Dental Association
https://www.readbyqxmd.com/read/27865440/hemoglobin-of-12-g-dl-and-above-is-not-associated-with-increased-cardiovascular-morbidity-in-children-on-hemodialysis
#5
Michelle N Rheault, Julia T Molony, Thomas Nevins, Charles A Herzog, Blanche M Chavers
In adults on chronic hemodialysis, achieving a hemoglobin concentration of 12g/dl and above with erythropoiesis stimulating agents leads to increased cardiovascular events and mortality, but this may not be true in children. Therefore, we conducted a retrospective cohort study of pediatric patients (under 18) from the Centers for Medicare and Medicaid Services End Stage Renal Disease (ESRD) Clinical Performance Measures (CPM) project (2000 to 2008) merged with the United States Renal Data System. Hemoglobin was determined from the Clinical Performance Measures data, and beginning annually on January 1st of the next year, patients were followed for up to 1 year...
November 16, 2016: Kidney International
https://www.readbyqxmd.com/read/27831525/narcotic-and-antidepressant-use-and-hospital-readmission-rates-in-children-with-functional-abdominal-pain
#6
Kathleen J Holland, William E Bennett
Functional abdominal pain is a common presentation in the pediatric population, and it carries a large financial and emotional burden. The objective of this study was to describe the association between the use of narcotics and antidepressants and hospital readmission in children admitted for abdominal pain without an organic cause. We analyzed data from the Pediatric Health Information System database. A multivariate logistical regression model was used to assess the association between medication type and hospital readmission rates within 30 and 90 days...
November 8, 2016: Clinical Pediatrics
https://www.readbyqxmd.com/read/27826707/diagnostic-yield-of-outpatient-pediatric-echocardiograms-impact-of-indications-and-specialty
#7
Sean M Lang, Elijah Bolin, Sarah Hardy, Xinyu Tang, R Thomas Collins
Multiple reports have shown that echocardiograms are neither cost-effective nor of high diagnostic yield for a number of indications. This study sought to evaluate the impact of indications and provider type on the diagnostic yield of first-time outpatient pediatric echocardiograms. All initial echocardiograms interpreted at our institution from February 2009 to December 2014 were reviewed retrospectively. Positive findings were defined as any abnormality of structure or function. Ordering physicians were grouped as Primary Care, Subspecialist, or Cardiologist...
November 8, 2016: Pediatric Cardiology
https://www.readbyqxmd.com/read/27797636/multiple-complex-chronic-conditions-and-pediatric-hospice-utilization-among-california-medicaid-beneficiaries-2007-2010
#8
Lisa C Lindley
BACKGROUND: Over 42,000 children die each year in the United States, including many with multiple complex chronic conditions (MCCCs), but little is known about whether the presence of MCCCs influences families to utilize pediatric hospice care. OBJECTIVE: The study objective was to examine the relationship between MCCCs and pediatric hospice utilization among Medicaid beneficiaries. METHODS: A retrospective, longitudinal cohort design was conducted with 2007-2010 California Medicaid data to examine the relationship between MCCCs (i...
October 31, 2016: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/27743336/improving-adherence-to-care-recommendations-using-a-community-health-worker-chw-intervention-with-the-pediatric-medical-home
#9
Sarah P Justvig, Justine Li, Giuseppina Caravella, Minqin Chen, Hua Wang, Lisa A Benz Scott, Susmita Pati
While CHW interventions improve health outcomes, evidence identifying specific domains of CHW-delivered support resulting in positive outcomes is limited. Our goals were to identify domains of CHW-delivered support that assist families with adhering to recommended pediatric care; and, to identify predictors of successful completion of an enriched medical home intervention (EMHI) using trained CHWs making home visits to provide health education and support positive health behaviors. We performed a prospective descriptive study of 88 families participating in a protocol-based EMHI...
October 14, 2016: Journal of Community Health
https://www.readbyqxmd.com/read/27707916/antibiotic-prescribing-by-physicians-versus-nurse-practitioners-for-pediatric-upper-respiratory-infections
#10
Elisabeth H Ference, Jin-Young Min, Rakesh K Chandra, James W Schroeder, Jody D Ciolino, Amy Yang, Jane Holl, Stephanie Shintani Smith
BACKGROUND: This study investigates differences in antibiotic prescribing rates for pediatric upper respiratory infections (URIs) between physicians and nurse practitioners (NPs). METHODS: Visits by children <18 years old diagnosed with URI to physicians or NPs between 2001 and 2010 were abstracted from the National Ambulatory Medical Care Survey and National Hospital Ambulatory Care Survey. Logistic regression analyses examined variations in antibiotic prescribing rates...
December 2016: Annals of Otology, Rhinology, and Laryngology
https://www.readbyqxmd.com/read/27707900/patient-and-visit-level-variables-associated-with-late-arrival-to-pediatric-clinic-appointments
#11
Shona C Hang, Kristen Hassmiller Lich, Kevin J Kelly, Diane M Howell, Michael J Steiner
We conducted a cross-sectional study to evaluate timeliness of patient arrival at a pediatric multispecialty clinic. Bivariate and ordered logistic regression analyses were conducted to determine the odds of late arrival by specified patient- and visit-level characteristics. A total of 64 856 visits were available for analysis, of which 6513 (10.0%) were late arrivals. The odds of late arrival were higher for patients who spoke English (odds ratio [OR] = 1.34, P < .001) compared with those who spoke Spanish, had Medicaid (OR = 1...
October 5, 2016: Clinical Pediatrics
https://www.readbyqxmd.com/read/27701831/clinical-outcomes-of-levalbuterol-versus-racemic-albuterol-in-pediatric-patients-with-asthma-propensity-score-matching-approach-in-a-medicaid-population
#12
Jing Yuan, Zhiqiang Kevin Lu, Yanjun Zhang, Jun Wu, Bryan L Love, Richard M Schulz
OBJECTIVE: Racemic albuterol and levalbuterol are used to treat acute episodes of asthma. The main objective of this study was to compare levalbuterol therapy to albuterol therapy on incidence rates of subsequent emergency department (ED) visits and hospitalizations. METHOD: We conducted a retrospective cohort study of asthmatic children who had pharmacy refills for levalbuterol/albuterol in the South Carolina Medicaid database in 2002-2011. Children receiving levalbuterol were matched to those receiving albuterol using propensity score matching technique...
October 4, 2016: Pediatric Pulmonology
https://www.readbyqxmd.com/read/27693902/the-effect-of-pediatric-palliative-care-policy-on-hospice-utilization-among-california-medicaid-beneficiaries
#13
Lisa C Lindley
CONTEXT: California implemented pediatric palliative care legislations that allowed children to receive curative and supportive care from diagnosis of a life-threatening serious illness in 2010. Palliative care policies may improve access to hospice care as children near end of life. OBJECTIVES: The aim of this study was to examine the effect of the palliative care policy on hospice utilization for children and their families was investigated. METHODS: Using 2007 and 2010 California Medicaid data, a difference-in-difference analysis was conducted to analyze hospice use (i...
November 2016: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/27663966/payments-to-pediatricians-in-the-sunshine-act
#14
Dominique J Karas, Jathin Bandari, Danielle N Browning, Bruce L Jacobs, Benjamin J Davies
Under the Sunshine Act, pharmaceutical and product industry payments to physicians are reported in a public database. We sought to characterize payments received by pediatricians in the first full year of disclosures in 2014. We used the National Centers for Medicare and Medicaid Services Open Payment files to identify pediatricians who received payments. Payment characteristics were stratified, and descriptive statistical analysis was performed, including mean, median, and ranges of payments. Between January 1, 2014, and December 31, 2014, 35 697 pediatricians received payments amounting to $30 031 960...
September 23, 2016: Clinical Pediatrics
https://www.readbyqxmd.com/read/27660059/federally-qualified-health-center-access-and-emergency-department-use-among-children
#15
Julia B Nath, Shaughnessy Costigan, Feng Lin, Eric Vittinghoff, Renee Y Hsia
OBJECTIVE: To determine whether increasing access to federally qualified health centers (FQHCs) in California was associated with decreased rates of emergency department (ED) use by children without insurance or insured by Medicaid. METHODS: We combined several data sets to longitudinally analyze 58 California counties between 2005 and 2013. We defined access to FQHCs by county using 2 measures: FQHC sites per 100 square miles between 2005 and 2012 and percentage of Medicaid-insured and uninsured children served by FQHCs from 2008 to 2013...
September 22, 2016: Pediatrics
https://www.readbyqxmd.com/read/27650201/end-of-life-care-for-hispanic-children-a-study-of-california-medicaid-beneficiaries
#16
Lisa C Lindley, Laura V Trujillo
INTRODUCTION: More than 8,000 Hispanic children die annually in the United States; yet little is known about the end-of-life care utilized. The purpose of this study was to examine the children and family characteristics associated with end-of-life care for Hispanic children. METHOD: A sample of 370 Hispanic children was created, using the 2009-2010 California Medicaid data. The relationship between child and family characteristics and end-of-life care utilization (i...
December 2016: Hispanic Health Care International: the Official Journal of the National Association of Hispanic Nurses
https://www.readbyqxmd.com/read/27618589/improving-discharge-instructions-in-a-pediatric-emergency-department-impact-of-a-quality-initiative
#17
Bolanle Akinsola, John Cheng, April Zmitrovich, Naghma Khan, Shabnam Jain
BACKGROUND: Effective communication between physician and patient is essential to optimize care after discharge from the emergency department (ED). Written discharge care instructions (DCI) complement verbal instructions and have been shown to improve communication and patient management. In 2012, Centers for Medicare and Medicaid Services proposed a quality measure (OP-19) that assesses compliance with key elements considered essential for high-quality written DCI. OBJECTIVE: To evaluate the impact of a QI intervention on improving quality of written DCI in a pediatric emergency department (PED)...
September 9, 2016: Pediatric Emergency Care
https://www.readbyqxmd.com/read/27618284/financial-loss-for-inpatient-care-of-medicaid-insured-children
#18
Jeffrey D Colvin, Matt Hall, Jay G Berry, Laura M Gottlieb, Jessica L Bettenhausen, Samir S Shah, Evan S Fieldston, Patrick H Conway, Paul J Chung
Importance: Medicaid payments tend to be less than the cost of care. Federal Disproportionate Share Hospital (DSH) payments help hospitals recover such uncompensated costs of Medicaid-insured and uninsured patients. The Patient Protection and Affordable Care Act reduces DSH payments in anticipation of fewer uninsured patients and therefore decreased uncompensated care. However, unlike adults, few hospitalized children are uninsured, while many have Medicaid coverage. Therefore, DSH payment reductions may expose extensive Medicaid financial losses for hospitals serving large absolute numbers of children...
September 12, 2016: JAMA Pediatrics
https://www.readbyqxmd.com/read/27617372/pediatric-dentistry-specialty-as-part-of-a-longer-continuum-of-care-a-commentary
#19
H Barry Waldman, Rick Rader, Stephen Sulkes, Steven P Perlman
The transition of teenagers with special needs to young adulthood is a complex period for the children and their families. This transition is especially difficult when it comes to securing needed oral health care. The teenager is forced to transfer from the services of an age defined pediatric dental specialist with training to provide care for individuals with special needs, to 1) general practitioners with limited formal training and often unwillingness to provide care and 2) at a period when most states provide limited or lack of adult dental Medicaid programs...
2016: Journal of Clinical Pediatric Dentistry
https://www.readbyqxmd.com/read/27613363/variation-in-advanced-imaging-for-pediatric-patients-with-abdominal-pain-discharged-from-the-ed
#20
Kimberly B Horner, Amy Jones, Li Wang, Daniel G Winger, Jennifer R Marin
BACKGROUND: Pediatric abdominal pain visits to emergency departments (ED) are common. The objectives of this study are to assess variation in imaging (ultrasound ±computed tomography [CT]) and factors associated with isolated CT use. METHODS: This was a retrospective cohort study of ED visits for pediatric abdominal pain resulting in discharge from 16 regional EDs from 2007 to 2013. Primary outcome was ultrasound or CT imaging. Secondary outcome was isolated CT use...
August 26, 2016: American Journal of Emergency Medicine
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