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https://www.readbyqxmd.com/read/28800266/impact-of-shared-decision-making-on-asthma-quality-of-life-and-asthma-control-among-children
#1
Yhenneko J Taylor, Hazel Tapp, Lindsay E Shade, Tsai-Ling Liu, Jessica Lauren Mowrer, Michael F Dulin
OBJECTIVE: Few studies have examined the effectiveness of shared decision making (SDM) in clinical practice. This study evaluated the impact of SDM on quality of life and symptom control in children with asthma. METHODS: We conducted a prospective 3-year study in six community-based practices serving a low-income patient population. Practices received training on SDM using an evidence-based toolkit. Patients aged 2 to 17 with a diagnosis of asthma were identified from scheduling and billing data...
August 11, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/28771405/pediatric-readmissions-after-hospitalizations-for-lower-respiratory-infections
#2
Mari M Nakamura, Alan M Zaslavsky, Sara L Toomey, Carter R Petty, Maria C Bryant, Alexandra T Geanacopoulos, Ashish K Jha, Mark A Schuster
BACKGROUND AND OBJECTIVE: Lower respiratory infections (LRIs) are among the most common reasons for pediatric hospitalization and among the diagnoses with the highest number of readmissions. Characterizing LRI readmissions would help guide efforts to prevent them. We assessed variation in pediatric LRI readmission rates, risk factors for readmission, and readmission diagnoses. METHODS: We analyzed 2008-2009 Medicaid Analytic eXtract data for patients <18 years of age in 26 states...
August 2017: Pediatrics
https://www.readbyqxmd.com/read/28765382/health-care-expenditures-and-utilization-for-children-with-noncomplex-chronic-disease
#3
Erik R Hoefgen, Annie L Andrews, Troy Richardson, Matthew Hall, John M Neff, Michelle L Macy, Jessica L Bettenhausen, Samir S Shah, Katherine A Auger
BACKGROUND: Pediatric health care expenditures and use vary by level of complexity and chronic illness. We sought to determine expenditures and use for children with noncomplex chronic diseases (NC-CDs). METHODS: We performed a retrospective, cross-sectional analysis of Medicaid enrollees (ages 0-18 years) from January 1, 2012, through December 31, 2013, using administrative claims (the Truven MarketScan Medicaid Database). Patients were categorized by chronicity of illness by using 3M Health Information System's Clinical Risk Groups (CRGs) as follows: without chronic diseases (WO-CDs) (CRG 1-2), NC-CDs (CRG 3-5), and complex chronic diseases (C-CDs) (CRG 6-9)...
August 1, 2017: Pediatrics
https://www.readbyqxmd.com/read/28765380/high-expenditure-pharmaceutical-use-among-children-in-medicaid
#4
Eyal Cohen, Matt Hall, Ruth Lopert, Brian Bruen, Lisa J Chamberlain, Naomi Bardach, Jennifer Gedney, Bonnie T Zima, Jay G Berry
BACKGROUND AND OBJECTIVES: Medication use may be a target for quality improvement, cost containment, and research. We aimed to identify medication classes associated with the highest expenditures among pediatric Medicaid enrollees and to characterize the demographic, clinical, and health service use of children prescribed these medications. METHODS: Retrospective, cross-sectional study of 3 271 081 Medicaid-enrolled children. Outpatient medication spending among high-expenditure medication classes, defined as the 10 most expensive among 261 mutually exclusive medication classes, was determined by using transaction prices paid to pharmacies by Medicaid agencies and managed care plans among prescriptions filled and dispensed in 2013...
August 1, 2017: Pediatrics
https://www.readbyqxmd.com/read/28730629/emergency-department-use-for-acute-rhinosinusitis-insurance-dependent-for-children-and-adults
#5
Regan W Bergmark, Stacey L Ishman, Katie M Phillips, Michael J Cunningham, Ahmad R Sedaghat
OBJECTIVES/HYPOTHESIS: Patients with Medicaid or self-pay insurance status are more likely to present to the emergency department (ED) for uncomplicated acute rhinosinusitis (ARS). Our aim was to determine if this pattern holds true for both pediatric and adult visits. STUDY DESIGN: Cross-sectional study using the 2005 to 2012 National Hospital Ambulatory Medical Care Surveys and National Ambulatory Medical Care Surveys. METHODS: We included all visits with International Classification of Diseases, Ninth Revision codes for ARS and without codes for ARS complications...
July 21, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28719499/a-retrospective-cohort-study-of-the-incidence-healthcare-resource-utilization-and-costs-of-icd-9-diagnosed-influenza-and-related-complications-in-us-children
#6
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 healthcare resource utilization (HRU) and costs in US children. METHODS: Children ≥6 months and <18 years old diagnosed with influenza using ICD-9 codes and enrolled in a health plan during at least one influenza season between 2010-2014 were matched to similar patients without diagnosed influenza (GSK study identifier: HO-15-15728)...
July 14, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28715295/prevalence-of-home-parenteral-and-enteral-nutrition-in-the-united-states
#7
Manpreet S Mundi, Adele Pattinson, Megan T McMahon, Jacob Davidson, Ryan T Hurt
BACKGROUND: Malnutrition is highly prevalent and associated with increased morbidity and mortality. Studies continue to reveal significant clinical benefits with nutrition support, including improved wound healing, reduction in complications and length of stay, and mortality. Due to these benefits, the prevalence of home parenteral and enteral nutrition (HPEN) continues to increase worldwide. In the United States, given our healthcare insurance landscape, it has been very difficult to ascertain the true prevalence of HPEN...
July 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28688994/comparison-of-30-day-emergency-department-bouncebacks-after-pediatric-versus-adult-urologic-surgery
#8
Courtney L Shepard, Julian Wan
INTRODUCTION: More pediatric patients seem to present to the emergency department (ED) for non-urgent matters after urologic procedures than adult patients. Under new and expanding healthcare reform, pediatric urologists may be penalized for these visits. We compare our 30-day postoperative bounceback rates to the ED and the acuity of the concerns in these populations. MATERIALS AND METHODS: All urology consults at our institution are maintained on a prospectively tracked database...
June 20, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28679018/underdiagnosis-and-lower-rates-of-office-visits-for-overweight-obese-pediatric-patients-in-rural-compared-with-urban-areas
#9
Christine SanGiovanni, James McElligott, Kristen Morella, William Basco
OBJECTIVES: This study compared the number of children enrolled in Medicaid in rural and urban areas of South Carolina with an overweight/obesity diagnosis and the mean rates of office visits with overweight/obesity diagnosed. METHODS: Medicaid claims data from 2012 for children in three South Carolina counties, categorized as urban, rural high resource, and rural low resource, were used to identify those who had been diagnosed as being overweight/obese during any encounter...
July 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28676248/the-weekend-effect-on-morbidity-and-mortality-among-pediatric-epilepsy-admissions
#10
Timothy Wen, Daniel R Kramer, Steve Sirot, Lianne Ho, Alimohammad S Moalem, Steven Y Cen, David Millett, Christianne Heck, R Aaron Robison, William J Mack, Charles Y Liu
BACKGROUND: Pediatric epilepsy is one of the most common neurological disorders with low mortality and high morbidity, often requiring hospitalization. Weekend admissions have been shown to be associated with worse outcomes compared with their weekday counterparts. To date, no study has assessed the impact of weekend admission on clinical and quality outcomes in the pediatric epilepsy population. METHODS: Children with epilepsy were identified from the 2000, 2003, 2006, and 2009 Kids Inpatient Database...
June 2, 2017: Pediatric Neurology
https://www.readbyqxmd.com/read/28669287/prevalence-of-psychotherapy-surrounding-initiation-of-psychotropic-polypharmacy-in-the-medicaid-insured-population-1999-2010
#11
Juan M Hincapie-Castillo, Xinyue Liu, Regina Bussing, Almut G Winterstein
OBJECTIVE: This research aimed to quantify the prevalence of psychotherapy among Medicaid-insured patients within six months of initiating psychotropic medication polypharmacy (PMP). METHODS: Using the Medicaid Analytic eXtract database for 29 states from 1999 to 2010, investigators established ten two-year cohorts of pediatric and adult patients who received two or more psychotropic drugs with a 45-day overlapping days' supply. Among PMP initiators, the prevalence of psychotherapy services, identified from encounter claims via Current Procedural Terminology and Healthcare Common Procedure Coding System codes, was calculated for the six months before and the six months after initiation of PMP...
July 3, 2017: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/28654202/socioeconomic-factors-affect-the-selection-of-proton-radiation-therapy-for-children
#12
Colette J Shen, Chen Hu, Matthew M Ladra, Amol K Narang, Craig E Pollack, Stephanie A Terezakis
BACKGROUND: Proton radiotherapy remains a limited resource despite its clear potential for reducing radiation doses to normal tissues and late effects in children in comparison with photon therapy. This study examined the impact of race and socioeconomic factors on the use of proton therapy in children with solid malignancies. METHODS: This study evaluated 12,101 children (age ≤ 21 years) in the National Cancer Data Base who had been diagnosed with a solid malignancy between 2004 and 2013 and had received photon- or proton-based radiotherapy...
June 27, 2017: Cancer
https://www.readbyqxmd.com/read/28650250/a-retrospective-longitudinal-claims-based-comparison-of-concomitant-diagnoses-between-individuals-with-and-without-down-syndrome
#13
Amanda M Kong, Dana Hurley, Kristin A Evans, Diana Brixner, Csilla Csoboth, Jeannie Visootsak
BACKGROUND: Individuals with Down syndrome (DS) experience various comorbidities in excess of the prevalence seen among the non-DS population. However, the extent of the excess burden of comorbidities specifically within commercially and publicly insured DS populations aged < 21 years is not currently known. OBJECTIVES: To (a) describe the most common diagnoses among individuals with DS who have either commercial or Medicaid insurance and (b) compare the prevalence of those diagnoses between DS cases and non-DS controls...
July 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28646002/preparation-for-transition-to-adult-care-among-medicaid-insured-adolescents
#14
Gregory S Sawicki, Katharine C Garvey, Sara L Toomey, Kathryn A Williams, J Lee Hargraves, Thomas James, Jean L Raphael, Angelo P Giardino, Mark A Schuster, Jonathan A Finkelstein
BACKGROUND: Parents of children with chronic illness consistently report suboptimal preparation for transition from pediatric- to adult-focused health care. Little data are available on transition preparation for low-income youth in particular. METHODS: We conducted a mailed survey of youth with chronic illness enrolled in 2 large Medicaid health plans to determine the quality of transition preparation using the Adolescent Assessment of Preparation for Transition (ADAPT)...
July 2017: Pediatrics
https://www.readbyqxmd.com/read/28640775/prevalence-of-non-accidental-trauma-among-children-at-acs-verified-pediatric-trauma-centers
#15
David D A Bogumil, Natalie E Demeter, Karen 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 non-accidental trauma (NAT), have large financial burdens associated with them due to treatment costs and long-term effects of abuse. Clinicians that 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...
June 20, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28634166/development-and-validation-of-the-pediatric-medical-complexity-algorithm-pmca-version-2-0
#16
Tamara D Simon, Mary Lawrence Cawthon, Jean Popalisky, Rita Mangione-Smith
BACKGROUND AND OBJECTIVES: The Pediatric Medical Complexity Algorithm (PMCA) was developed to stratify children by level of medical complexity. We sought to refine PMCA and evaluate its performance based on the duration of eligibility and completeness of Medicaid data. METHODS: PMCA version 1.0 was applied to a cohort of 299 children insured by Washington State Medicaid with ≥1 Seattle Children's Hospital outpatient, emergency department, and/or inpatient encounter in 2012...
June 20, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28622983/the-effect-of-a-comprehensive-care-transition-model-on-cost-and-utilization-for-medically-complex-children-with-cerebral-palsy
#17
Steven W Howard, Zidong Zhang, Paula Buchanan, Eric Armbrecht, Christine Williams, Geneva Wilson, Janna Hutchinson, Lindsey Pearson, Samantha Ellsworth, Caitlin M Byler, Travis Loux, Jing Wang, Steph Bernell, Nicholas Holekamp
INTRODUCTION: Our aim was to evaluate cost and acute care utilization related to an organized approach to care coordination and transitional care after major acute care hospitalization for children with medical complexities, including cerebral palsy. METHODS: A retrospective cohort of 32 patients from Ranken Jordan Pediatric Bridge Hospital (RJPBH) who received the Care Beyond the Bedside model was compared with 151 patients receiving standard care elsewhere across Missouri...
June 13, 2017: Journal of Pediatric Health Care
https://www.readbyqxmd.com/read/28617244/continuity-of-care-in-infancy-and-early-childhood-health-outcomes
#18
Elizabeth Enlow, Molly Passarella, Scott A Lorch
BACKGROUND AND OBJECTIVES: Continuity of care is a key aspect of the patient-centered medical home and improves pediatric outcomes. Health care reform requires high-quality data to demonstrate its continued value. We hypothesized that increased provider continuity in infancy will reduce urgent health care use and increase receipt of preventive services in early childhood. METHODS: Continuity, using the Usual Provider of Care measure, was calculated across all primary care encounters during the first year of life in a prospectively-constructed cohort of 17 773 infants receiving primary care from birth through 3 years at 30 clinics...
July 2017: Pediatrics
https://www.readbyqxmd.com/read/28612354/quantifying-disparities-in-accessibility-and-availability-of-pediatric-primary-care-across-multiple-states-with-implications-for-targeted-interventions
#19
Monica Gentili, Pravara Harati, Nicoleta Serban, Jean O'Connor, Julie Swann
OBJECTIVE: To quantify disparities in accessibility and availability of pediatric primary care by modeling interventions across multiple states that compare publicly insured versus privately insured children, and urban versus rural communities. DATA SOURCES: Secondary data sources include 2013 National Plan and Provider Enumeration System, 2009 MAX Medicaid claims, 2012 American Community Survey. STUDY DESIGN: The study models accessibility and availability of care for all children in seven states...
June 13, 2017: Health Services Research
https://www.readbyqxmd.com/read/28609734/assessment-of-treatment-patterns-and-healthcare-costs-associated-with-probable-lennox-gastaut-syndrome
#20
J Eric Piña-Garza, Georgia D Montouris, Francis Vekeman, Wendy Y Cheng, Edward Tuttle, Philippe Giguere-Duval, Mei Sheng Duh, Vivienne Shen, Timothy B Saurer, Jouko Isojarvi
Lennox-Gastaut syndrome (LGS) is a chronic and severe form of epilepsy characterized by intractable seizures, cognitive impairment, and abnormal electroencephalogram findings with slow spike-wave complexes. It typically presents before age 8, but symptoms continue into adulthood and require lifelong treatment associated with significant clinical burden. Data on LGS-associated healthcare utilization and costs are limited. In this study we use a claims-based LGS classifier based on random forest methodology to identify patients with probable LGS from the a Medicaid multi-state database and assess its prevalence across the age spectrum, healthcare utilization, treatment patterns, costs, and comorbid conditions...
June 10, 2017: Epilepsy & Behavior: E&B
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