National Healthcare Quality and Disparities Report
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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
326 to 350 of 406 Research Studies DisplayedFoote EM, Singleton RJ, Holman RC
AHRQ Author: Steiner CA
Lower respiratory tract infection hospitalizations among American Indian/Alaska Native children and the general United States child population.
The authors described the change in lower respiratory tract infection-associated hospitalization rates for American Indian and Alaskan Native (AI/AN) children and for the general US child population aged less than 5 years. They found that the 2009-2011 AI/AN child average annual LRTI-associated hospitalization rate was 1.5 times higher than the US child rate. The Alaska and Southwest regions had the highest rates. The disparity was greatest for infant pneumonia-associated and 2009-2010 H1N1 influenza-associated hospitalizations.
AHRQ-authored.
Citation: Foote EM, Singleton RJ, Holman RC .
Lower respiratory tract infection hospitalizations among American Indian/Alaska Native children and the general United States child population.
Int J Circumpolar Health 2015;74:29256. doi: 10.3402/ijch.v74.29256.
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Keywords: Children/Adolescents, Healthcare Cost and Utilization Project (HCUP), Hospitalization, Racial and Ethnic Minorities, Respiratory Conditions
Gilbert AL, Downs SM
Medical legal partnership and health informatics impacting child health: interprofessional innovations.
This article describes the interprofessional nature of the Medical Legal Partnership ( MLP) model itself, illustrates the work that was done to craft this innovative health informatics approach to implementing MLP, and demonstrates how pediatricians social workers and attorneys may work together to improve child health outcomes.
AHRQ-funded; HS020640.
Citation: Gilbert AL, Downs SM .
Medical legal partnership and health informatics impacting child health: interprofessional innovations.
J Interprof Care 2015;29(6):564-9. doi: 10.3109/13561820.2015.1029066..
Keywords: Health Information Technology (HIT), Children/Adolescents, Clinical Decision Support (CDS)
Feinstein J, Dai D, Zhong W
Potential drug-drug interactions in infant, child, and adolescent patients in children's hospitals.
This study assessed the prevalence and characteristics of potential drug-drug interactions (PDDI) among pediatric patients treated in children’s hospitals. It found that exposure to “major” potential drug2drug interactions occurs in 41 percent of pediatric hospitalizations in children’s hospitals. One-half of all these exposures were due to less common specific drug pairs (3 percent of patients exposed per hospital day).
AHRQ-funded; HS018425.
Citation: Feinstein J, Dai D, Zhong W .
Potential drug-drug interactions in infant, child, and adolescent patients in children's hospitals.
Pediatrics 2015 Jan;135(1):e99-108. doi: 10.1542/peds.2014-2015..
Keywords: Children/Adolescents, Patient Safety, Medication
Bauer NS, Anand V, Carroll AE
Secondhand smoke exposure, parental depressive symptoms and preschool behavioral outcomes.
In order to learn about the association of second-hand smoke (SHS) exposure to behavioral conditions among preschoolers, the researchers looked at billing and pharmacy claims and medical encounter level data. They found that SHS is associated with behavioral conditions such as attention deficit-hyperactivity disorder and disruptive behavior disorder.
AHRQ-funded; HS018453; HS017939
Citation: Bauer NS, Anand V, Carroll AE .
Secondhand smoke exposure, parental depressive symptoms and preschool behavioral outcomes.
J Pediatr Nurs. 2015 Jan-Feb;30(1):227-35. doi: 10.1016/j.pedn.2014.06.004..
Keywords: Children/Adolescents, Behavioral Health, Tobacco Use
Auger KA, Simon TD, Cooperberg D
Summary of STARNet: Seamless Transitions and (Re)admissions Network.
The Seamless Transitions and (Re)admissions Network (STARNet) met in December 2012 to synthesize ongoing hospital-to-home transition work, discuss goals, and develop a plan to centralize transition information in the future. The authors of this report reviewed the current knowledge regarding hospital-to-home transitions, outlined the challenges of measuring and reducing readmissions, and highlighted research gaps, listing potential measures for transition quality.
AHRQ-funded; HS020506.
Citation: Auger KA, Simon TD, Cooperberg D .
Summary of STARNet: Seamless Transitions and (Re)admissions Network.
Pediatrics 2015 Jan;135(1):164-75. doi: 10.1542/peds.2014-1887.
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Keywords: Children/Adolescents, Hospital Discharge, Transitions of Care, Quality Improvement, Quality of Care
Christian RB, Gaynes BN, Saavedra LM
Use of antipsychotic medications in pediatric and young adult populations: future research needs.
This article describes and prioritizes future research needs regarding antipsychotic treatment in youth, focusing on within-class and between-class drug comparisons with regard to key population subgroups, efficacy and effectiveness outcomes, and adverse event outcomes. Future research needs are delineated in detail as well as study designs that could be used to address them.
AHRQ-funded; 290200710056I.
Citation: Christian RB, Gaynes BN, Saavedra LM .
Use of antipsychotic medications in pediatric and young adult populations: future research needs.
J Psychiatr Pract 2015 Jan;21(1):26-36. doi: 10.1097/01.pra.0000460619.10429.4c..
Keywords: Medication, Children/Adolescents, Behavioral Health, Comparative Effectiveness, Patient-Centered Outcomes Research
Baird J, Davies B, Hinds PS
What impact do hospital and unit-based rules have upon patient and family-centered care in the pediatric intensive care unit?
This qualitative, grounded theory study identified the existence of explicit and implicit rules in a pediatric intensive care unit, all of which negatively affected the family's ability to receive care that was attentive to their needs. The rules also placed the registered nurse in the challenging position of serving as rule enforcer and facilitator of patient and family-centered care.
AHRQ-funded; HS000063.
Citation: Baird J, Davies B, Hinds PS .
What impact do hospital and unit-based rules have upon patient and family-centered care in the pediatric intensive care unit?
J Pediatr Nurs 2015 Jan-Feb;30(1):133-42. doi: 10.1016/j.pedn.2014.10.001.
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Keywords: Children/Adolescents, Intensive Care Unit (ICU), Patient and Family Engagement, Patient-Centered Healthcare, Children/Adolescents
Shetgiri R, Lee SC, Tillitski J
Why adolescents fight: a qualitative study of youth perspectives on fighting and its prevention.
The aim of this study was to examine fighters’ and non-fighters’ perspectives on fighting and strategies to prevent fighting, by use of focus groups. It found that non-fighters use various strategies to avoid fighting, whereas fighters are aware of few alternatives to fighting. Conflicting parental messages about fighting may enhance the likelihood of fighting.
AHRQ-funded; HS022418.
Citation: Shetgiri R, Lee SC, Tillitski J .
Why adolescents fight: a qualitative study of youth perspectives on fighting and its prevention.
Acad Pediatr. 2015 Jan-Feb;15(1):103-10. doi: 10.1016/j.acap.2014.06.020..
Keywords: Children/Adolescents, Prevention, Risk
Berry JG, Hall M, Neff J
Children with medical complexity and Medicaid: spending and cost savings.
The authors described the expenditures for children with medical complexity insured by Medicaid across the care continuum, reported the increasingly large amount of spending on hospital care for these children, and presented a business case that estimates how cost savings might be achieved from potential reductions in hospital and emergency department use and shows how the savings could underwrite investments in outpatient and community care. They concluded by discussing the importance of these findings in the context of Medicaid's quality of care and health care reform.
AHRQ-funded; HS023092.
Citation: Berry JG, Hall M, Neff J .
Children with medical complexity and Medicaid: spending and cost savings.
Health Aff 2014 Dec;33(12):2199-206. doi: 10.1377/hlthaff.2014.0828.
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Keywords: Children/Adolescents, Medicaid, Healthcare Costs, Inpatient Care, Quality of Care
Cai L, Wu Y, Cheskin LI
Effect of childhood obesity prevention programmes on blood lipids: a systematic review and meta-analysis.
This study, the first systematic, quantitative study of childhood obesity prevention programs on blood lipids in high-income countries found that most interventions (70 percent) showed similar significant or no effects on adiposity- and lipid outcomes; 15 percent of interventions improved both adiposity- and lipids outcomes; 55 percent had no significant effects on either. These programs had a significant desirable effect on LDL-C and HDL-C.
AHRQ-funded; 290200710061I
Citation: Cai L, Wu Y, Cheskin LI .
Effect of childhood obesity prevention programmes on blood lipids: a systematic review and meta-analysis.
Obes Rev. 2014 Dec;15(12):933-44. doi: 10.1111/obr.12227..
Keywords: Children/Adolescents, Obesity, Prevention, Outcomes, Social Determinants of Health
Raghavan R, Brown DS, Allaire BT
Medicaid expenditures on psychotropic medications for maltreated children: a study of 36 States.
The authors aimed to quantify the magnitude of Medicaid expenditures incurred in the purchase of psychotropic drugs for children with histories of abuse or neglect. They concluded that Medicaid agencies should focus their cost containment strategies on antidepressants and antimanic drugs, consider expanding primary care case management arrangements, and expand use of instruments such as the Child Behavior Checklist to identify and treat high-need children.
AHRQ-funded; HS020269.
Citation: Raghavan R, Brown DS, Allaire BT .
Medicaid expenditures on psychotropic medications for maltreated children: a study of 36 States.
Psychiatr Serv 2014 Dec;65(12):1445-51. doi: 10.1176/appi.ps.201400028.
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Keywords: Children/Adolescents, Healthcare Costs, Medicaid, Medication, Behavioral Health
McIntosh S, Cirillo D, Wood N
Patient evaluation of an acute care pediatric telemedicine service in urban neighborhoods.
The authors characterized health problems prompting neighborhood telemedicine use and to assessed parent perceptions of its value. They found that family preferences and the high value placed on neighborhood telemedicine suggest such service is important, and that service provided by neighborhood telemedicine holds potential to meet a large demand for care of acute childhood illness.
AHRQ-funded; HS018912.
Citation: McIntosh S, Cirillo D, Wood N .
Patient evaluation of an acute care pediatric telemedicine service in urban neighborhoods.
Telemed J E Health 2014 Dec;20(12):1121-6. doi: 10.1089/tmj.2014.0032.
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Keywords: Children/Adolescents, Health Services Research (HSR), Patient Experience, Telehealth, Urban Health
Simeone RM, Oster ME, Cassell CH
AHRQ Author: Gray DT
Pediatric inpatient hospital resource use for congenital heart defects.
The authors sought to estimate healthcare costs for infants, children, and adolescents with congenital heart defects (CHDs). Using the 2009 Healthcare Cost and Utilization Project Kids' Inpatient Database (KID), they found that hospitalizations for children with CHDs have disproportionately high hospital costs compared with other pediatric hospitalizations, and the 17% of hospitalizations with critical CHD diagnoses accounted for 27% of CHD hospital costs.
AHRQ-authored.
Citation: Simeone RM, Oster ME, Cassell CH .
Pediatric inpatient hospital resource use for congenital heart defects.
Birth Defects Res A Clin Mol Teratol 2014 Dec;100(12):934-43. doi: 10.1002/bdra.23262.
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Keywords: Cardiovascular Conditions, Children/Adolescents, Healthcare Costs, Healthcare Cost and Utilization Project (HCUP), Hospitalization
Bundy DG, Gaur AH, Billett AL
Preventing CLABSIs among pediatric hematology/oncology inpatients: national collaborative results.
This study assessed the feasibility of a multicenter effort to standardize central line (CL) care and central line-associated bloodstream infection (CLABSI) tracking and to quantify the impact of standardizing these processes on CLABSI rates. It found a reduction of 28 percent in the mean CLABSI rate from 2.85 to 2.04 per 1,000 CL days over almost 3 years.
AHRQ-funded; HS019590
Citation: Bundy DG, Gaur AH, Billett AL .
Preventing CLABSIs among pediatric hematology/oncology inpatients: national collaborative results.
Pediatrics. 2014 Dec;134(6):e1678-85. doi: 10.1542/peds.2014-0582..
Keywords: Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Quality of Care, Children/Adolescents
Broder-Fingert S, Ferrone CF, Giauque A
Residents' knowledge and comfort with caring for children with autism spectrum disorder.
The authors evaluated a cohort of pediatric residents’ knowledge of and comfort with caring for children with autism spectrum disorder (ASD). Their data suggest that more education is needed to increase resident competence in caring for individuals with ASD. Residents reported very low rates of direct communication with patients with ASD and no residents had used pictures to communicate with these patients. The authors found it concerning that few residents had found resources to help these patients with their communication needs. At the same time, comfort with using pictures to communicate was scored higher than other domains.
AHRQ-funded; HS000063.
Citation: Broder-Fingert S, Ferrone CF, Giauque A .
Residents' knowledge and comfort with caring for children with autism spectrum disorder.
Clin Pediatr 2014 Dec;53(14):1390-2. doi: 10.1177/0009922814526982.
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Keywords: Autism, Children/Adolescents, Education: Continuing Medical Education, Children/Adolescents, Clinician-Patient Communication
Saloner B, Matone M, Kreider AR
Second-generation antipsychotic use among stimulant-using children, by organization of Medicaid mental health.
The authors compared differences in second-generation antipsychotic utilization among Medicaid-enrolled children across fee-for-service, integrated managed care, and managed behavioral health carve-out organizational structures. They found that carve-outs, versus other arrangements, were associated with lower second-generation antipsychotic use.
AHRQ-funded; HS020269; HS018550.
Citation: Saloner B, Matone M, Kreider AR .
Second-generation antipsychotic use among stimulant-using children, by organization of Medicaid mental health.
Psychiatr Serv 2014 Dec;65(12):1458-64. doi: 10.1176/appi.ps.201300574.
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Keywords: Children/Adolescents, Healthcare Utilization, Medicaid, Medication, Behavioral Health
Angier H, Gregg J, Gold R
Understanding how low-income families prioritize elements of health care access for their children via the optimal care model.
The researchers explored low-income parents’ perspectives on accessing health care. Interviews with 29 Oregon parents revealed that affordability and limited availability were seen as barriers to care; while a continuous relationship with a health care provider helped them overcome these barriers. Parents also described the difficult decisions they made between affordability and acceptability in order to get the best care they could for their children.
AHRQ-funded; HS018569.
Citation: Angier H, Gregg J, Gold R .
Understanding how low-income families prioritize elements of health care access for their children via the optimal care model.
BMC Health Serv Res 2014 Nov 19;14:585. doi: 10.1186/s12913-014-0585-2..
Keywords: Access to Care, Children/Adolescents, Low-Income, Social Determinants of Health, Healthcare Costs
Shaikh U, Nettiksimmons J, Joseph JG
Collaborative practice improvement for childhood obesity in rural clinics: the Healthy Eating Active Living Telehealth Community of Practice (HEALTH COP).
The authors assessed the impact of participation in a virtual quality improvement (QI) learning network on adherence to clinical guidelines for childhood obesity prevention in rural clinics. They found that children who received care from clinicians who led the implementation of the intervention at their clinic showed significant improvements in nutrition and physical activity. Virtual QI learning networks in geographically dispersed clinics can significantly increase clinicians' adherence to guidelines for childhood obesity and improve access to recommended care for rural and underserved children.
AHRQ-funded; HS018567.
Citation: Shaikh U, Nettiksimmons J, Joseph JG .
Collaborative practice improvement for childhood obesity in rural clinics: the Healthy Eating Active Living Telehealth Community of Practice (HEALTH COP).
Am J Med Qual 2014 Nov-Dec;29(6):467-75. doi: 10.1177/1062860613506252.
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Keywords: Children/Adolescents, Evidence-Based Practice, Health Information Technology (HIT), Lifestyle Changes, Nutrition, Obesity, Prevention, Quality Improvement, Rural Health, Telehealth
Fritz SA, Hogan PG, Singh LN
Contamination of environmental surfaces with Staphylococcus aureus in households with children infected with methicillin-resistant S aureus.
This study of the households of 50 children with active or recent culture-positive community-associated methicillin-resistant staphylococcus aureus (MRSA) infection found MRSA-contaminated surfaces in 23 of the 50 households, most frequently form the bed linens (18 percent), television remote control (16 percent), and bathroom hand towel (15 percent).
AHRQ-funded; HS021736
Citation: Fritz SA, Hogan PG, Singh LN .
Contamination of environmental surfaces with Staphylococcus aureus in households with children infected with methicillin-resistant S aureus.
JAMA Pediatr. 2014 Nov;168(11):1030-8. doi: 10.1001/jamapediatrics.2014.1218..
Keywords: Patient Safety, Healthcare-Associated Infections (HAIs), Methicillin-Resistant Staphylococcus aureus (MRSA), Children/Adolescents, Racial and Ethnic Minorities
Aldrich H, Gance-Cleveland B, Schmiege S
Identification and assessment of childhood obesity by school-based health center providers.
The authors evaluated obesity care assessment practices of school-based health center (SBHC) providers prior to completing training on obesity guidelines. They found that most providers reported using BMI to assess weight, reported screening for hypertension 100% of the time and cardiovascular disease 93.9% of the time, and approximately two thirds reported requesting total cholesterol and lipid profile laboratory assessments.
AHRQ-funded; HS018646.
Citation: Aldrich H, Gance-Cleveland B, Schmiege S .
Identification and assessment of childhood obesity by school-based health center providers.
J Pediatr Health Care 2014 Nov-Dec;28(6):526-33. doi: 10.1016/j.pedhc.2014.05.002.
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Keywords: Children/Adolescents, Guidelines, Education, Obesity, Prevention
Shah RK, Stey AM, Jantana KR
Identification of opportunities for quality improvement and outcome measurement in pediatric otolaryngology.
This study evaluated perioperative outcomes in pediatric otolaryngology through analysis of records residing in the American College of Surgeons (ACS) National Surgical Quality Improvement Program (ACS-NSQIP) database. It found that although the overall rate of major postoperative morbidity in pediatric otolaryngology is low, the following areas may be targeted for targeted quality-improvement interventions: tracheostomy, airway reconstruction, mastoidectomy, and abscess drainage.
AHRQ-funded; HS022932
Citation: Shah RK, Stey AM, Jantana KR .
Identification of opportunities for quality improvement and outcome measurement in pediatric otolaryngology.
JAMA Otolaryngol Head Neck Surg. 2014 Nov;140(11):1019-26. doi: 10.1001/jamaoto.2014.2067..
Keywords: Surgery, Children/Adolescents, Quality Improvement, Outcomes, Patient-Centered Outcomes Research
Balamuth F, Weiss SL, Neuman MI
Pediatric severe sepsis in U.S. children's hospitals.
The objective of this study was to compare epidemiological trends in the prevalence, resource utilization, and mortality of pediatric patients with severe sepsis and septic shock. The researchers found that the prevalence of severe sepsis/septic shock has increased in the studied U.S. children’s hospitals between 2004 and 2012, whereas resource utilization and mortality have decreased over that time period.
AHRQ-funded; HS021114
Citation: Balamuth F, Weiss SL, Neuman MI .
Pediatric severe sepsis in U.S. children's hospitals.
Pediatr Crit Care Med. 2014 Nov;15(9):798-805. doi: 10.1097/pcc.0000000000000225..
Keywords: Hospitals, Children/Adolescents, Critical Care
Davidson AJ, McCormick EV, Dickinson LM
Population-level obesity surveillance: monitoring childhood body mass index z-score in a safety-net system.
The objective of this study was to determine the utility of repeated patient-level body mass index (BMI) measurements among higher-risk patients seen at safety-net clinics as a community-level monitoring tool for overweight and obesity population trends. The researchers found that childhood obesity prevalence was high, with substantial progression to overweight and obesity from first to last visit and concluded that clinically derived BMI z-score per person-year measures can effectively show population trends not observed using standard weight status categories.
AHRQ-funded; HS021138.
Citation: Davidson AJ, McCormick EV, Dickinson LM .
Population-level obesity surveillance: monitoring childhood body mass index z-score in a safety-net system.
Acad Pediatr 2014 Nov-Dec;14(6):632-8. doi: 10.1016/j.acap.2014.06.007.
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Keywords: Children/Adolescents, Community-Based Practice, Obesity
Aldrich H, Gance-Cleveland B, Schmiege S
School-based health center providers' treatment of overweight children.
The purpose of this study was to determine self-reported treatment practices of school-based health center (SBHC) providers when caring for overweight/obese children. SBHC providers reported patient/parent barriers to be more significant to treatment than clinician/setting barriers. Most providers (97%) indicated childhood overweight needs treatment, yet only 36% indicated that they initiate treatment in children who do not want to control their weight. SBHC providers also did not commonly refer these children to specialists.
AHRQ-funded; HS018646.
Citation: Aldrich H, Gance-Cleveland B, Schmiege S .
School-based health center providers' treatment of overweight children.
J Pediatr Nurs 2014 Nov-Dec;29(6):521-7. doi: 10.1016/j.pedn.2014.05.007.
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Keywords: Care Management, Children/Adolescents, Education, Obesity, Prevention, Obesity: Weight Management
Carayon P, Li Y, Kelly MM
Stimulated recall methodology for assessing work system barriers and facilitators in family-centered rounds in a pediatric hospital.
In this study, the researchers implemented and evaluated the use of a stimulated recall methodology for collective confrontation in the context of family-centered rounds (FCRs). They concluded that their study demonstrated the value of the stimulated recall methodology to identify a range of work system factors that either positively or negatively influence family engagement during FCRs.
AHRQ-funded; HS018680.
Citation: Carayon P, Li Y, Kelly MM .
Stimulated recall methodology for assessing work system barriers and facilitators in family-centered rounds in a pediatric hospital.
Appl Ergon 2014 Nov;45(6):1540-6. doi: 10.1016/j.apergo.2014.05.001..
Keywords: Hospitals, Children/Adolescents, Teams, Research Methodologies