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https://www.readbyqxmd.com/read/28476461/adding-social-determinant-data-changes-children-s-hospitals-readmissions-performance
#1
Marion R Sills, Matthew Hall, Gretchen J Cutler, Jeffrey D Colvin, Laura M Gottlieb, Michelle L Macy, Jessica L Bettenhausen, Rustin B Morse, Evan S Fieldston, Jean L Raphael, Katherine A Auger, Samir S Shah
OBJECTIVES: To determine whether social determinants of health (SDH) risk adjustment changes hospital-level performance on the 30-day Pediatric All-Condition Readmission (PACR) measure and improves fit and accuracy of discharge-level models. STUDY DESIGN: We performed a retrospective cohort study of all hospital discharges meeting criteria for the PACR from 47 hospitals in the Pediatric Health Information database from January to December 2014. We built four nested regression models by sequentially adding risk adjustment factors as follows: chronic condition indicators (CCIs); PACR patient factors (age and sex); electronic health record-derived SDH (race, ethnicity, payer), and zip code-linked SDH (families below poverty level, vacant housing units, adults without a high school diploma, single-parent households, median household income, unemployment rate)...
May 2, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28474997/availability-of-outpatient-mental-health-care-by-pediatricians-and-child-psychiatrists-in-five-u-s-cities
#2
Shireen Cama, Monica Malowney, Anna Jo Bodurtha Smith, Margaret Spottswood, Elisa Cheng, Louis Ostrowsky, Jose Rengifo, J Wesley Boyd
The authors sought to assess the availability of outpatient mental health care through pediatrician and child psychiatrist offices in the United States and to characterize differences in appointment availability by location, provider type, and insurance across five cities. To do so, the authors posed as parents of a 12-year-old child with depression, gave a predetermined insurance type, and asked to make the first available appointment with the specified provider. They called the offices of 601 individual pediatricians and 312 child psychiatrists located in five U...
January 1, 2017: International Journal of Health Services: Planning, Administration, Evaluation
https://www.readbyqxmd.com/read/28426457/race-differences-in-initial-presentation-early-treatment-and-1-year-outcomes-of-pediatric-crohn-s-disease-results-from-the-improvecarenow-network
#3
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...
May 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28420264/the-rate-of-sepsis-in-a-national-pediatric-population-2006-to-2012
#4
Kristin A Schuller, Benson S Hsu, Allyson B Thompson
INTRODUCTION: The rate of pediatric severe sepsis is reported to be on the rise in the United States, increasing by approximately 6000 cases annually. The goal of this study was to determine the rate of pediatric sepsis per 100 000 inpatient discharges over time. METHODS: The 2006, 2009, and 2012 Agency for Healthcare Research and Quality Healthcare Cost Utilization Project Kid's Inpatient Databases were used to analyze the rate of sepsis in children over time...
April 1, 2017: Clinical Pediatrics
https://www.readbyqxmd.com/read/28373108/development-and-implementation-of-the-family-experiences-with-coordination-of-care-survey-quality-measures
#5
Courtney Gidengil, Layla Parast, Q Burkhart, Julie Brown, Marc N Elliott, K Casey Lion, Elizabeth A McGlynn, Eric C Schneider, Rita Mangione-Smith
OBJECTIVE: Ensuring high-quality care coordination for children with medical complexity (CMC) could yield significant health and economic benefits because they account for one-third of pediatric health care expenditures. The objective of this study was to develop and field test the Family Experiences with Coordination of Care (FECC) survey, which facilitates assessment of 20 new caregiver-reported quality measures for CMC. METHODS: We identified caregivers of Medicaid-insured CMC aged 0 to 17 years in Minnesota and Washington state, categorized by the Pediatric Medical Complexity Algorithm as having complex chronic disease...
March 31, 2017: Academic Pediatrics
https://www.readbyqxmd.com/read/28365103/race-and-outcomes-in-gastroschisis-repair-a-nationwide-analysis
#6
Ye Kyung Song, Omar Nunez Lopez, Hemalkumar B Mehta, Fredrick J Bohanon, Yesenia Rojas-Khalil, Kanika A Bowen-Jallow, Ravi S Radhakrishnan
BACKGROUND: The incidence of gastroschisis has increased 30% between the periods 1995-2005 and 2006-2012, with the largest increase in Black neonates born to Black mothers younger than 20years old. OBJECTIVE: Racial disparities in peri- and post-operative outcomes have been previously identified in several types of adult and pediatric surgical patients. Is there an association between race and clinical outcomes and healthcare resource utilization in neonates with gastroschisis? METHODS: Retrospective study using national administrative data from the Kid's Inpatient Database (KID) from 2006, 2009, and 2012 for neonates (age<28days) with gastroschisis...
March 11, 2017: Journal of Pediatric Surgery
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
#7
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
#8
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
#9
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
#10
Joshua R Watson, Ling Wang, Jennifer Klima, Melissa Moore-Clingenpeel, Sean Gleeson, Kelly Kelleher, Preeti Jaggi
Background.: Healthcare claims are underutilized 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. Rates of total antibiotic and azithromycin prescriptions dispensed were determined by county of patient residence. 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...
June 1, 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
#11
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)...
May 2017: Academic Pediatrics
https://www.readbyqxmd.com/read/28283418/urban-residence-neighborhood-poverty-race-ethnicity-and-asthma-morbidity-among-children-on-medicaid
#12
Corinne A Keet, Elizabeth C Matsui, Meredith C McCormack, Roger D 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 United States is not known. OBJECTIVE: This study sought to examine relationships between residence in poor and urban areas, race/ethnicity, and asthma morbidity among children with asthma who are enrolled in Medicaid...
March 8, 2017: Journal of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/28260997/children-with-intellectual-disability-and-hospice-utilization
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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)...
March 2017: Pediatrics
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