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https://www.readbyqxmd.com/read/28342349/evaluation-of-individual-and-area-level-factors-as-modifiers-of-the-association-between-warm-season-temperature-and-pediatric-asthma-morbidity-in-atlanta-ga
#1
Cassandra R O'Lenick, Andrea Winquist, Howard H Chang, Michael R Kramer, James A Mulholland, Andrew Grundstein, Stefanie Ebelt Sarnat
INTRODUCTION: Previous studies have found associations between respiratory morbidity and high temperatures; however, few studies have explored associations in potentially sensitive sub-populations. METHODS: We evaluated individual and area-level factors as modifiers of the association between warm-season (May-Sept.) temperature and pediatric respiratory morbidity in Atlanta. Emergency department (ED) visit data were obtained for children, 5-18 years old, with primary diagnoses of asthma or respiratory disease (diagnoses of upper respiratory infections, bronchiolitis, pneumonia, chronic obstructive pulmonary disease, asthma, or wheeze) in 20-county Atlanta during 1993-2012...
March 22, 2017: Environmental Research
https://www.readbyqxmd.com/read/28338416/impact-of-a-complex-care-management-model-on-cost-and-utilization-among-adolescents-and-young-adults-with-special-care-and-health-needs
#2
Daniel D Maeng, Susan R Snyder, Thomas W Davis, Janet F Tomcavage
Adolescents and young adults with special care and health needs in the United States-many of whom have Medicaid coverage-at the transition phase between pediatric and adult care often experience critical care gaps. To address this challenge, a new model-referred to as Comprehensive Care Clinic (CCC)-has been developed and implemented by Geisinger Health System since 2012. CCC comprises a care team, consisting of a generalist physician, advanced practitioner, pharmacist, and a nurse case manager, that develops and closely follows a coordinated care plan...
March 24, 2017: Population Health Management
https://www.readbyqxmd.com/read/28330970/variation-in-family-experience-of-pediatric-inpatient-care-as-measured-by-child-hcahps
#3
Sara L Toomey, Marc N Elliott, Alan M Zaslavsky, David J Klein, Sifon Ndon, Shannon Hardy, Melody Wu, Mark A Schuster
BACKGROUND: Making national comparisons of family experience of inpatient pediatric care has been limited by the lack of a publicly available survey. The Agency for Healthcare Research and Quality and Centers for Medicare & Medicaid Services commissioned development of the Child Hospital Consumer Assessment of Healthcare Providers and Systems Survey to address this gap. Using Child Hospital Consumer Assessment of Healthcare Providers and Systems Survey, we measured performance of hospitals in a national field test...
March 22, 2017: Pediatrics
https://www.readbyqxmd.com/read/28329388/healthcare-claims-data-an-underutilized-tool-for-pediatric-outpatient-antimicrobial-stewardship
#4
Joshua R Watson, Ling Wang, Jennifer Klima, Melissa Moore-Clingenpeel, Sean Gleeson, Kelly Kelleher, Preeti Jaggi
Background: Healthcare claims are under-utilized to identify factors associated with high outpatient antibiotic use. Methods: We evaluated ambulatory encounter claims of Medicaid-insured children in 34 Ohio counties in 2014. 1) Rates of total antibiotic and azithromycin prescriptions dispensed were determined by county of patient residence. 2) Standardized treatment rates by county were estimated for uncomplicated upper respiratory tract encounters (acute otitis media, pharyngitis, sinusitis, presumed viral infection) after adjusting for patient age and encounter provider type...
March 9, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28286057/quality-of-primary-care-for-children-with-disabilities-enrolled-in-medicaid
#5
Alyna T Chien, Karen A Kuhlthau, Sara L Toomey, Jessica A Quinn, Megumi J Okumura, Dennis Z Kuo, Amy J Houtrow, Jeanne Van Cleave, Mary Beth Landrum, Jisun Jang, Isabel Janmey, Michael J Furdyna, Mark A Schuster
OBJECTIVE: The quality of primary care delivered to Medicaid-insured children with disabilities (CWD) is unknown. We used the newly validated CWD algorithm (CWDA) to examine CWD prevalence among Medicaid enrollees 1 to 18 years old, primary care quality for CWD, and differences in primary care quality for CWD and non-CWD. METHODS: Cross-sectional study using 2008 Medicaid Analytic eXtract claims data from 9 states, including children with at least 11 months of enrollment (N = 2,671,922 enrollees)...
March 9, 2017: Academic Pediatrics
https://www.readbyqxmd.com/read/28283418/urban-residence-neighborhood-poverty-race-ethnicity-and-asthma-morbidity-among-children-in-medicaid
#6
Corinne A Keet, Elizabeth Matsui, Meredith C McCormack, Roger Peng
BACKGROUND: Although poor-urban (inner-city) areas are thought to have high asthma prevalence and morbidity, we recently found that inner-cities do not have higher prevalent pediatric asthma. Whether asthma morbidity is higher in inner-city areas across the U.S. not known. OBJECTIVE: To examine relationships between residence in poor and urban areas, race/ethnicity, and asthma morbidity among children with asthma enrolled in Medicaid. METHODS: Children aged 5-19 enrolled in Medicaid in 2009-2010 were included...
March 7, 2017: Journal of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/28260997/children-with-intellectual-disability-and-hospice-utilization
#7
Lisa C Lindley, Mari Beth Colman, John T Meadows
Over 42,000 children die each year in the United States, including those with intellectual disability (ID). Survival is often reduced when children with intellectual disability also suffer from significant motor dysfunction, progressive congenital conditions, and comorbidities. Yet, little is known about hospice care for children with intellectual disability. The purpose of this study was to explore the relationship between intellectual disability and hospice utilization. Additionally, we explored whether intellectual disability combined with motor dysfunction, progressive congenital conditions, and comorbidities influenced pediatric hospice utilization...
February 2017: Journal of Hospice and Palliative Nursing: JHPN
https://www.readbyqxmd.com/read/28259619/improving-adolescent-preventive-care-in-an-urban-pediatric-clinic-capturing-missed-opportunities
#8
Tina Kumra, Shweta Antani, Sara B Johnson, Sallie J Weaver
PURPOSE: To increase the proportion of adolescents with Medicaid who receive preventive care services in an urban pediatric clinic. METHODS: A quality improvement intervention was implemented at an urban pediatric primary care clinic between November 2013 and October 2014. The intervention systematically "flipped" acute visits into well-care visits for patients ages 12-21 years, when overdue. The primary process measure was the percentage of acute visits expanded to include well-care components out of total eligible opportunities...
March 1, 2017: Journal of Adolescent Health: Official Publication of the Society for Adolescent Medicine
https://www.readbyqxmd.com/read/28259302/temporal-trends-in-utilization-of-transthoracic-echocardiography-for-common-outpatient-pediatric-cardiology-diagnoses-over-the-past-15%C3%A2-years
#9
Ritu Sachdeva, Curtis D Travers, Courtney E McCracken, Cyrus Samai, Robert M Campbell, Timothy C Slesnick, William L Border
BACKGROUND: No data exist regarding the temporal trends in utilization of transthoracic echocardiography (TTE) in an outpatient pediatric cardiology setting. This study evaluates the trends in utilization of TTE for common diagnoses known to have low diagnostic yield and the factors influencing these trends. METHODS: Patients evaluated at our pediatric cardiology clinics from January 2000 to December 2014 and discharged with final diagnoses of innocent murmur, noncardiac chest pain, benign syncope, and palpitations were included...
March 2017: Journal of the American Society of Echocardiography
https://www.readbyqxmd.com/read/28258807/medication-assisted-treatment-for-adolescents-in-specialty-treatment-for-opioid-use-disorder
#10
Kenneth A Feder, Noa Krawczyk, Brendan Saloner
PURPOSE: The American Academy of Pediatrics recently recommended that pediatricians consider medication-assisted treatment (MAT) for adolescents with severe opioid use disorders. Little is known about adolescents' current use of MAT. METHODS: We use data on episodes of specialty treatment for heroin or opioid use (n = 139,092) from a database of publicly funded treatment programs in the U.S. We compare the proportions of adolescents and adults who received MAT, first using unadjusted comparison of proportions, then using logistic regression to adjust for potential confounders...
February 28, 2017: Journal of Adolescent Health: Official Publication of the Society for Adolescent Medicine
https://www.readbyqxmd.com/read/28225427/race-differences-in-initial-presentation-early-treatment-and-1-year-outcomes-of-pediatric-crohn-s-disease-results-from-the-improvecarenow-network
#11
Jennifer L Dotson, Michele Cho, Josh Bricker, Michael D Kappelman, Deena J Chisolm, Gitit Tomer, Wallace V Crandall
BACKGROUND: Racially disparate care has been shown to contribute to suboptimal health care outcomes for minorities. Using the ImproveCareNow network, we investigated differences in management and outcomes of pediatric patients with Crohn's disease at diagnosis and 1-year postdiagnosis. METHODS: ImproveCareNow is a learning health network for pediatric inflammatory bowel disease. It contains prospective, longitudinal data from outpatient encounters. This retrospective study included all patients with Crohn's disease ≤21 years, September 2006 to October 2014, with the first recorded encounter ≤90 days from date of diagnosis and an encounter 1 year ±60 days...
February 20, 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28209637/the-impact-of-payer-source-on-trauma-outcomes-in-a-pediatric-population
#12
Felecia A Lee, Ashley M Hervey, Arash Sattarin, Aaron Deeds, Gina M Berg, Kimberly Molik
OBJECTIVES: Determine if there were differences in conclusions drawn regarding disparities in trauma outcomes based on literature-derived payer source definitions in a pediatric population. PATIENTS AND METHODS: Retrospective registry review of admitted pediatric trauma patients (≤17 years of age) at a level II pediatric trauma facility. Eligible patients were categorized into 3 payer source definitions: definition 1: commercially insured, Medicaid, uninsured; definition 2: insured, uninsured; definition 3: commercially insured, underinsured...
February 16, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28167005/acute-care-revisits-after-adenotonsillectomy-in-a-pediatric-medicaid-population-in-ohio
#13
Dmitry Tumin, Hina Walia, Vidya T Raman, Joseph D Tobias
INTRODUCTION: Guidelines for inpatient admission after pediatric tonsillectomy have been proposed to improve the safety of this procedure. This study examined the association between performing adenotonsillectomy in an inpatient setting and acute care revisits within 30 days among children enrolled in a Medicaid Accountable Care Organization in Ohio. METHODS: The Accountable Care Organization's claims database was queried for adenotonsillectomies performed in children ages 0-18 years in 2008-2014...
March 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28159872/utilization-of-mental-health-services-after-mild-pediatric-traumatic-brain-injury
#14
Nathalia Jimenez, Alex Quistberg, Monica S Vavilala, Kenneth M Jaffe, Frederick P Rivara
BACKGROUND: Mild traumatic brain injury injuries (mTBIs), including concussions, represent >2 million US pediatric emergency department visits annually. Post-mTBI mental health symptoms are prominent and often attributed to the mTBI. This study examined whether individuals seeking post-mTBI mental health care had previous mental health diagnoses or a new onset of such disorders, and determined if mental health care utilization differed by race/ethnicity. METHODS: Retrospective cohort study, using the Medicaid Marketscan claims national dataset (2007-2012)...
February 3, 2017: Pediatrics
https://www.readbyqxmd.com/read/28143914/pediatric-accountable-care-organizations-insight-from-early-adopters
#15
James M Perrin, Edward Zimmerman, Andrew Hertz, Timothy Johnson, Tom Merrill, David Smith
Partly in response to incentives in the Affordable Care Act, there has been major growth in accountable care organizations (ACO) in both the private and public sectors. For several reasons, growth of ACOs in pediatric care has been more modest than for older populations. The American Academy of Pediatrics collaborated with Leavitt Partners, LLC, to carry out a study of pediatric ACOs, including a series of 5 case studies of diverse pediatric models, a scan of Medicaid ACOs, and a summit of leaders in pediatric ACO development...
January 31, 2017: Pediatrics
https://www.readbyqxmd.com/read/28103923/risk-adjustment-methods-for-all-payer-comparative-performance-reporting-in-vermont
#16
Karl Finison, MaryKate Mohlman, Craig Jones, Melanie Pinette, David Jorgenson, Amy Kinner, Tim Tremblay, Daniel Gottlieb
BACKGROUND: As the emphasis in health reform shifts to value-based payments, especially through multi-payer initiatives supported by the U.S. Center for Medicare & Medicaid Innovation, and with the increasing availability of statewide all-payer claims databases, the need for an all-payer, "whole-population" approach to facilitate the reporting of utilization, cost, and quality measures has grown. However, given the disparities between the different populations served by Medicare, Medicaid, and commercial payers, risk-adjustment methods for addressing these differences in a single measure have been a challenge...
January 19, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28060177/influence-of-insurance-type-on-the-access-to-pediatric-care-for-children-with-distal-radius-torus-fractures
#17
Harrison Potak, Christopher A Iobst
BACKGROUND: Previous literature has demonstrated that pediatric orthopaedic patients with private insurance have less difficulty obtaining appointments than those with Medicaid. Not all injuries of an orthopaedic nature, however, require specialist care. This study evaluated the willingness of pediatricians to provide care for minor orthopaedic injuries and whether or not the patient's insurance status influenced the decision to provide care. METHODS: Ninety-nine pediatric primary care offices were randomly selected from 2 regions in Florida...
January 5, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28030420/changes-in-primary-care-graduate-medical-education-are-not-correlated-with-indicators-of-need-are-states-missing-an-opportunity-to-strengthen-their-primary-care-workforce
#18
Anastasia J Coutinho, Kathleen Klink, Peter Wingrove, Stephen Petterson, Robert L Phillips, Andrew Bazemore
PURPOSE: Federal and state graduate medical education (GME) funding exceeds $15 billion annually. It is critical to understand mechanisms to align undergraduate medical education (UME) and GME to meet workforce needs. This study aimed to determine whether states' primary care GME (PCGME) trainee growth correlates with indicators of need. METHOD: Data from the American Medical Association Physician Masterfile, the Association of American Medical Colleges, the American Association of the Colleges of Osteopathic Medicine, and the U...
December 27, 2016: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/27938695/feasibility-assessment-for-using-telehealth-technology-to-improve-access-to-dental-care-for-rural-and-underserved-populations
#19
Amy B Martin, Joni D Nelson, Grishma P Bhavsar, James McElligott, David Garr, Renata S Leite
OBJECTIVE: South Carolina Dental Association members were surveyed on telehealth knowledge, need, and interest in using it for access to care improvements. METHODS: Dependent variables were Medicaid patient population size (less than or greater than 10%), career stage (early to middle and advanced), and National Health Service Corps participation (yes or no). Practice and provider characteristics were screener questions. Data were collected electronically and analyzed with SAS...
December 2016: Journal of Evidence-based Dental Practice
https://www.readbyqxmd.com/read/27925425/preventing-acute-care-associated-venous-thromboembolism-in-adult-and-pediatric-patients-across-a-large-healthcare-system
#20
REVIEW
Timothy I Morgenthaler, Vilmarie Rodriguez
BACKGROUND: Although effective methods for venous thromboembolism prophylaxis (VTE-P) have been known for decades, reliable implementation has been challenging. OBJECTIVE: Develop reliable VTE-P systems for adult and for pediatric patients to reduce preventable venous thromboembolism (VTE). DESIGN: We used a discovery and diffusion system to first develop an effective system in 1 hospital location, and then spread the principle best practices across the entire 22-hospital system...
December 2016: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
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