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https://www.readbyqxmd.com/read/29141077/pediatric-use-of-antipsychotic-medications-before-and-after-medicaid-peer-review-implementation
#1
Julie M Zito, Mehmet Burcu, Stephen McKean, Rob Warnock, Jeffrey Kelman
No abstract text is available yet for this article.
November 15, 2017: JAMA Psychiatry
https://www.readbyqxmd.com/read/29140945/a-retrospective-cohort-study-of-the-incidence-health-care-resource-utilization-and-costs-of-international-classification-of-diseases-clinical-modification-9th-revision-diagnosed-influenza-and-related-complications-in-us-children
#2
Philip O Buck, David M Smith, Rahul Shenolikar, Debra E Irwin
BACKGROUND: There is a paucity of data on the clinical and economic impact of seasonal influenza in children. This study estimated the incidence of diagnosed influenza and related complications and associated health care resource utilization and costs in US children. METHODS: Children ≥6 months and <18 years old diagnosed with influenza using International Classification of Diseases, Clinical Modification, 9th revision codes and enrolled in a health plan during at least one influenza season between 2010 and 2014 were matched to similar patients without diagnosed influenza (GSK study identifier: HO-15-15728)...
December 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/29137557/the-impact-of-a-state-medicaid-peer-review-authorization-program-on-pediatric-use-of-antipsychotic-medications
#3
Dinci Pennap, Mehmet Burcu, Daniel J Safer, Julie Magno Zito
OBJECTIVE: This cross-sectional study assessed the impact of a peer-review program on the prevalence of pediatric antipsychotic use among Medicaid-insured youths in a Mid-Atlantic state. METHODS: Medicaid claims (2010-2014) were assessed among continuously enrolled youths in the 12 months before and after implementation of peer review. The study identified children ages zero to four preimplementation (N=118,815) and postimplementation (N=121,431), ages five to nine preimplementation (N=98,681) and postimplementation (N=107,872), and ages 10 to 17 preimplementation (N=154,696) and postimplementation (N=161,370)...
November 15, 2017: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/29133576/spillover-effects-of-adult-medicaid-expansions-on-children-s-use-of-preventive-services
#4
Maya Venkataramani, Craig Evan Pollack, Eric T Roberts
BACKGROUND: Since the passage of the Affordable Care Act, Medicaid enrollment has increased by ∼17 million adults, including many low-income parents. One potentially important, but little studied, consequence of expanding health insurance for parents is its effect on children's receipt of preventive services. METHODS: By using state Medicaid eligibility thresholds linked to the 2001-2013 Medical Expenditure Panel Surveys, we assessed the relationship between changes in adult Medicaid eligibility and children's likelihood of receiving annual well-child visits (WCVs)...
November 13, 2017: Pediatrics
https://www.readbyqxmd.com/read/29119824/an-innovative-health-care-delivery-model-for-children-with-medical-complexity
#5
Anne Elizabeth Glassgow, Molly A Martin, Rachel Caskey, Melishia Bansa, Michael Gerges, Mary Johnson, Monika Marko, Kenita Perry-Bell, Heather J Risser, Peter J Smith, Benjamin Van Voorhees
Children with medical complexity (CMC) account for a disproportionate share of pediatric health-care utilization and cost that is largely attributable to long hospitalizations, frequent hospital readmissions, and high use of emergency departments. In response, the Centers for Medicare and Medicaid Services Health Care Innovation Center supports the development and testing of innovative health-care payment and service delivery models. The purpose of this article is to describe the CMS-funded coordinated health care for complex kids (CHECK) program, an innovative system of health-care delivery that provides improved, comprehensive, and well-coordinated services to CMC...
September 2017: Journal of Child Health Care: for Professionals Working with Children in the Hospital and Community
https://www.readbyqxmd.com/read/29072963/medicaid-prior-authorization-policies-for-medication-treatment-of-attention-deficit-hyperactivity-disorder-in-young-children-united-states-2015
#6
Rachel L Hulkower, Meghan Kelley, Lindsay K Cloud, Susanna N Visser
OBJECTIVES: In 2011, the American Academy of Pediatrics updated its guidelines for the diagnosis and treatment of children with attention-deficit/hyperactivity disorder (ADHD) to recommend that clinicians refer parents of preschoolers (aged 4-5) for training in behavior therapy and subsequently treat with medication if behavior therapy fails to sufficiently improve functioning. Data available from just before the release of the guidelines suggest that fewer than half of preschoolers with ADHD received behavior therapy and about half received medication...
November 2017: Public Health Reports
https://www.readbyqxmd.com/read/29068874/prevalence-of-nonaccidental-trauma-among-children-at-american-college-of-surgeons-verified-pediatric-trauma-centers
#7
David D A Bogumil, Natalie E Demeter, Karen Kay Imagawa, Jeffrey S Upperman, Rita V Burke
BACKGROUND: Child abuse remains a national epidemic that has detrimental effects if unnoticed in the clinical setting. Extreme cases of child abuse, or nonaccidental trauma (NAT), have large financial burdens associated with them due to treatment costs and long-term effects of abuse. Clinicians who have additional training and experience with pediatric trauma are better equipped to detect signs of NAT and have more experience reporting it. This additional training and experience can be measured by using the American College of Surgeons (ACS) Pediatric Trauma verification...
November 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29061326/walk-in-model-for-ill-care-in-an-urban-academic-pediatric-clinic
#8
Stephen Warrick, John Morehous, Zeina M Samaan, Mona Mansour, Tracy Huentelman, Pamela J Schoettker, Srikant Iyer
OBJECTIVES: Since the Institute of Medicine's 2001 charge to reform healthcare, there has been a focus on the role of the medical home. Access to care in the proper setting and at the proper time is central to healthcare reform. We aimed to increase the volume of patients receiving care for acute illnesses within the medical home rather than the emergency department or urgent care center from 41% to 60%. METHODS: We used quality improvement methods to create a separate non-emergency care stream in a large academic primary care clinic serving 19,000 patients (> 90% Medicaid)...
October 20, 2017: Academic Pediatrics
https://www.readbyqxmd.com/read/29059095/predictors-of-hospitalization-length-of-stay-and-costs-of-care-among-adult-and-pediatric-inpatients-with-atopic-dermatitis-in-the-united-states
#9
Shanthi Narla, Derek Y Hsu, Jacob P Thyssen, Jonathan I Silverberg
Little is known about the risk factors of hospitalization for atopic dermatitis (AD). We sought to determine associations of hospitalization for AD in the United States. Data were analyzed from the 2002 to 2012 National Inpatient Sample. Atopic dermatitis hospitalizations were compared with controls, which included all hospitalizations without any diagnosis of AD excluding normal pregnancy/delivery, yielding a representative cohort of US hospitalizations. Both adults and children, who were admitted for AD or eczema, were more likely to have nonwhite race/ethnicity, lowest-quartile annual household income, Medicaid or no insurance and fewer chronic conditions...
October 21, 2017: Dermatitis
https://www.readbyqxmd.com/read/29054492/a-cost-analysis-of-an-interdisciplinary-pediatric-chronic-pain-clinic
#10
Nicole E Mahrer, Jeffrey I Gold, Michael Luu, Patricia Herman
Chronic pain is characterized by high rates of functional impairment, healthcare utilization, and associated costs. Research supports the use of comprehensive, interdisciplinary treatment approaches. However, many hospitals hesitate to offer this full range of services, especially to Medi-Cal/Medicaid patients whose services are reimbursed at low rates. This cost analysis examines the impact on hospital and insurance costs of patients' enrollment in an interdisciplinary pediatric pain clinic, which includes medication management, psychotherapy, biofeedback, acupuncture, and massage...
October 17, 2017: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/29029580/uncovering-longitudinal-health-care-behaviors-for-millions-of-medicaid-enrollees-a-multistate-comparison-of-pediatric-asthma-utilization
#11
Ross Hilton, Yuchen Zheng, Anne Fitzpatrick, Nicoleta Serban
BACKGROUND: This study introduces a framework for analyzing and visualizing health care utilization for millions of children, with a focus on pediatric asthma, one of the major chronic respiratory conditions. METHODS: The data source is the 2005 to 2012 Medicaid Analytic Extract claims for 10 Southeast states. The study population consists of Medicaid-enrolled children with persistent asthma. We translate multiyear, individual-level medical claims into sequences of discrete utilization events, which are modeled using Markov renewal processes and model-based clustering...
October 1, 2017: Medical Decision Making: An International Journal of the Society for Medical Decision Making
https://www.readbyqxmd.com/read/29019630/prolonged-hospital-discharge-for-children-with-technology-dependency-a-source-of-health-care-disparities
#12
Sarah A Sobotka, Rishi K Agrawal, Michael E Msall
Children with ventilator assistance have been supported in living at home since 1981 when parental advocacy ushered in a change to Medicaid policy. As the population of children who use medical technology such as long-term ventilation increases, we must critically evaluate our systems for preparing families for home life. Discharge delays persist in the modern era because of fragmentation between hospital and home systems. These discharge delays result in children spending time in less developmentally rich environments, further exacerbating the health and development disparities of children with complex disabilities...
October 1, 2017: Pediatric Annals
https://www.readbyqxmd.com/read/28985881/discontinuous-insurance-coverage-predicts-prolonged-hospital-stay-after-pediatric-adenotonsillectomy
#13
Dmitry Tumin, Adele King, Hina Walia, Joseph D Tobias, Vidya T Raman
BACKGROUND: Changes in health insurance coverage have been implicated in limiting access to care and increasing morbidity risk. The consequences of insurance discontinuity for surgical outcomes are unclear. In this study, we explored whether recent insurance discontinuity was associated with prolonged inpatient hospitalization after adenotonsillectomy in children. MATERIALS AND METHODS: We retrospectively evaluated single-center data on children aged 2-18 y undergoing adenotonsillectomy with overnight stay in 2009-2014...
October 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28975221/association-of-an-asthma-improvement-collaborative-with-health-care-utilization-in-medicaid-insured-pediatric-patients-in-an-urban-community
#14
Carolyn M Kercsmar, Andrew F Beck, Hadley Sauers-Ford, Jeffrey Simmons, Brandy Wiener, Lisa Crosby, Susan Wade-Murphy, Pamela J Schoettker, Pavan K Chundi, Zeina Samaan, Mona Mansour
Importance: Asthma is the most common chronic condition of childhood. Hospitalizations and emergency department (ED) visits for asthma are more frequently experienced by minority children and adolescents and those with low socioeconomic status. Objective: To reduce asthma-related hospitalizations and ED visits for Medicaid-insured pediatric patients residing in Hamilton County, Ohio. Design, Setting, and Participants: From January 1, 2010, through December 31, 2015, a multidisciplinary team used quality-improvement methods and the chronic care model to conduct interventions in inpatient, outpatient, and community settings in a large, urban academic pediatric hospital in Hamilton County, Ohio...
September 18, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28973290/spinal-fusion-for-pediatric-spondylolisthesis-national-trends-complications-and-short-term-outcomes
#15
Kavelin Rumalla, Chester K Yarbrough, Andrew J Pugely, Ian G Dorward
BACKGROUND: Current surgical management guidelines for pediatric spondylolisthesis (PS) are reliant on data from single-center cohorts. OBJECTIVE: To analyze national trends and predictors of short-term outcomes in spinal fusion surgery for PS by performing a retrospective cross-sectional analysis of the Kids' Inpatient Database (KID). METHODS: The KID (sampled every 3 yr) was queried from 2003 to 2012 to identify all cases (age 5-17) of spinal fusion for PS (n = 2646)...
July 7, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28964877/outpatient-visits-before-ambulatory-care-sensitive-hospitalization-of-children-using-medicaid
#16
Neal A deJong, Troy Richardson, Nicole Chandler, Michael J Steiner, Matt Hall, Jay Berry
OBJECTIVES: Hospitalizations for ambulatory care sensitive conditions (ACSC) are measured to indicate healthcare system quality, with the premise that fewer hospitalizations would occur with better preceding outpatient care. Our objective was to identify outpatient care received in the 7 days preceding acute pediatric hospitalizations, and to compare receipt of outpatient care by hospitalization type (ACSC vs. non-ACSC). METHODS: This was a retrospective, observational study using a 10-state database of Medicaid claims to identify outpatient visits within 7 days before acute, unplanned hospitalization for children ages 0-17 years...
September 27, 2017: Academic Pediatrics
https://www.readbyqxmd.com/read/28962069/a-decline-in-depression-treatment-following-fda-antidepressant-warnings-largely-explains-racial-ethnic-disparities-in-prescription-fills
#17
Nicholas J Carson, Ana M Progovac, Ye Wang, Benjamin L Cook
BACKGROUND: The Food and Drug Administration's 2004 antidepressant warning was followed by decreases in antidepressant prescribing for youth. This was due to declines in all types of depression treatment, not just the intended changes in antidepressant prescribing patterns. Little is known about how these patterns varied by race/ethnicity. METHOD: Data are Medicaid claims from four U.S. states (2002-2009) for youth ages 5-17. Interrupted time series analyses measured changes due to the warning in levels and trends, by race/ethnicity, of three outcomes: antidepressant prescription fills, depression treatment visits, and incident fluoxetine prescription fills...
September 29, 2017: Depression and Anxiety
https://www.readbyqxmd.com/read/28945103/insurance-coverage-and-acute-care-revisits-after-pediatric-ambulatory-tonsillectomy
#18
Dmitry Tumin, Vidya T Raman, Joseph D Tobias
We investigated whether patterns of health insurance coverage were associated with 30-day all-cause acute care revisits after ambulatory tonsillectomy at a free-standing quaternary-care pediatric hospital. Insurance patterns were classified from past encounters as continuous private, continuous Medicaid, Medicaid-to-private change, or private-to-Medicaid change. Among 478/675 boys/girls (age 9 ± 4 years) selected for analysis, 148 (13%) had 30-day revisits, whereas 96 (8%) changed from Medicaid to private insurance, and 99 (9%) changed from private insurance to Medicaid...
September 1, 2017: Clinical Pediatrics
https://www.readbyqxmd.com/read/28944292/early-head-start-pediatric-dental-use-and-oral-health-related-quality-of-life
#19
J M Burgette, J S Preisser, M Weinberger, R S King, R G Rozier
The objective of the study was to examine the mediating effect of child dental use on the effectiveness of North Carolina Early Head Start (EHS) in improving oral health-related quality of life (OHRQoL). In total, 479 parents of children enrolled in EHS and 699 parents of Medicaid-matched children were interviewed at baseline when children were approximately 10 mo old and 24 mo later. In this quasi-experimental study, mediation analysis was performed using the counterfactual framework analysis, which employed 2 logit models with random effects: 1) for the mediator as a function of the treatment and covariates and 2) for the outcome as a function of the treatment, mediator, and covariates...
October 2017: JDR Clinical and Translational Research
https://www.readbyqxmd.com/read/28943825/can-a-short-video-improve-inhaler-use-in-urban-youth
#20
Sara Brown, Victoria Tutag Lehr, Nathan French, Christopher Alan Giuliano
OBJECTIVE: The primary aim was to determine whether watching a short video in the inpatient setting could produce an immediate improvement in pediatric patients' asthma knowledge and inhaler technique. METHODS: This prospective, quasi-experimental, pre-post study was conducted in a single center, in Detroit, Michigan, which primarily serves an urban, African-American population. Patients were eligible if they were between 8- and 16-years-old, had asthma, and would be discharged with an albuterol metered-dose inhaler...
July 2017: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
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