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Medicaid pediatric

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
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...
October 5, 2016: Annals of Otology, Rhinology, and Laryngology
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
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
Lisa C Lindley
BACKGROUND: 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: To examine the effect of the palliative care policy on hospice utilization for children and their families was investigated. RESEARCH DESIGN: Using 2007 and 2010 California Medicaid data, a difference-in-difference analysis was conducted to analyze hospice use (i...
September 29, 2016: Journal of Pain and Symptom Management
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
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
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...
September 20, 2016: Hispanic Health Care International: the Official Journal of the National Association of Hispanic Nurses
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
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
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
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
Karen Hacker, Robert Penfold, Lisa N Arsenault, Fang Zhang, Stephen B Soumerai, Lawrence S Wissow
OBJECTIVE: In 2008, Massachusetts Medicaid implemented a pediatric behavioral health (BH) screening mandate. This study conducted a population-level, longitudinal policy analysis to determine the impact of the policy on ambulatory, emergency, and inpatient BH care in comparison with use of these services in California, where no similar policy exists. METHODS: With Medicaid Analytic Extract (MAX) data, an interrupted time-series analysis with control series design was performed to assess changes in service utilization in the 18 months (January 2008-June 2009) after a BH screening policy was implemented in Massachusetts and to compare service utilization with California's...
September 1, 2016: Psychiatric Services: a Journal of the American Psychiatric Association
Eric W Christensen, Anupam B Kharbanda, Heidi Vander Velden, Nathaniel R Payne
The objective of this study was to determine the patient characteristics and health care utilization patterns that predict frequent emergency department (ED) use (≥4 visits per year) over time to assist health care organizations in targeting patients for care management. This was a retrospective, population-based study of 13,265 Medicaid children aged 0-20 years who were attributed to a single pediatric accountable care organization for at least 2 consecutive years between June 2012 and May 2015. Year-to-year persistence as a frequent ED user was 36...
August 26, 2016: Population Health Management
Kate Russell, Sara E Oliver, Lillianne Lewis, Wanda D Barfield, Janet Cragan, Dana Meaney-Delman, J Erin Staples, Marc Fischer, Georgina Peacock, Titilope Oduyebo, Emily E Petersen, Sherif Zaki, Cynthia A Moore, Sonja A Rasmussen
CDC has updated its interim guidance for U.S. health care providers caring for infants born to mothers with possible Zika virus infection during pregnancy (1). Laboratory testing is recommended for 1) infants born to mothers with laboratory evidence of Zika virus infection during pregnancy and 2) infants who have abnormal clinical or neuroimaging findings suggestive of congenital Zika syndrome and a maternal epidemiologic link suggesting possible transmission, regardless of maternal Zika virus test results...
2016: MMWR. Morbidity and Mortality Weekly Report
Yunru Huang, JoAnne E Natale, Jamie L Kissee, Parul Dayal, Jennifer L Rosenthal, James P Marcin
STUDY OBJECTIVE: Among children requiring hospital admission or transfer, we seek to determine whether insurance is associated with the decision to either admit locally or transfer to another hospital. METHODS: This cross-sectional study used Healthcare Cost and Utilization Project 2012 Nationwide Emergency Department Sample. Pediatric patients receiving care in emergency departments (EDs) who were either admitted or transferred were included. Clinical Classifications Software was used to categorize patients into noninjury diagnostic cohorts...
August 20, 2016: Annals of Emergency Medicine
Ashley L Merianos, Cinnamon A Dixon, E Melinda Mahabee-Gittens
INTRODUCTION: This study aimed to determine the relationship between patients presenting to the pediatric emergency department (PED) and potential tobacco smoke exposure (TSE)-related illnesses. METHODS: A retrospective review of electronic medical records of pediatric emergency department patients (N = 116,084) was conducted. Sociodemographic characteristics, TSE-related illnesses, and TSE documentation were extracted. Logistic regression analyses were performed...
August 16, 2016: Journal of Pediatric Health Care
Ashley Andrews, Linda Franklin, Natasha Rush, Robin Witts, David Blanco, Harpreet Pall
OBJECTIVES: Few studies have examined the role health disparities play in pediatric gastrointestinal (GI) procedures. We hypothesized that health disparity factors affect whether patients undergo an emergent vs. non-emergent GI procedure. The aims were to characterize the existing pediatric population undergoing GI procedures at our institution and assess specific risk factors associated with emergent vs. non-emergent care. METHODS: We retrospectively reviewed the medical records of 2,110 patients undergoing GI procedures from January 2012-December 2014...
August 10, 2016: Journal of Pediatric Gastroenterology and Nutrition
Jeanette M Jerrell, Roger S McIntyre
BACKGROUND: The greater severity and burden of illness in individuals with early onset schizophrenia (ie, before age 18 years) deserves further investigation, specifically regarding its prevalence in community-based treatment and its association with other psychiatric or medical conditions. METHOD: A retrospective cohort design was employed using the South Carolina Medicaid claims database covering outpatient and inpatient medical services from January 1, 1999, through December 31, 2013, to identify patients aged ≤ 17 years with a diagnosis of schizophrenia spectrum disorders (ICD-9-CM)...
2016: Primary Care Companion to CNS Disorders
Rachel S Gruver, Chanelle T Bishop-Gilyard, Alexandra Lieberman, Marsha Gerdes, Senbagam Virudachalam, Andrew W Suh, Gurpreet K Kalra, Sheela N Magge, Justine Shults, Mark S Schreiner, Thomas J Power, Robert I Berkowitz, Alexander G Fiks
BACKGROUND: Evidence increasingly indicates that childhood obesity prevention efforts should begin as early as infancy. However, few interventions meet the needs of families whose infants are at increased obesity risk due to factors including income and maternal body mass index (BMI). Social media peer groups may offer a promising new way to provide these families with the knowledge, strategies, and support they need to adopt obesity prevention behaviors. OBJECTIVE: The aim of this study is to develop and pilot test a Facebook-based peer group intervention for mothers, designed to prevent pediatric obesity and promote health beginning in infancy...
2016: JMIR Research Protocols
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