National Healthcare Quality and Disparities Report
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Topics
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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
151 to 175 of 272 Research Studies DisplayedReeves SL, Tribble AC, Madden B
Antibiotic prophylaxis for children with sickle cell anemia.
This study calculated the proportion of children with sickle cell anemia (SCA) who received at least 300 days of antibiotic prophylaxis against invasive pneumococcal disease and identified predictors of receipt. Children with SCA between 3 months and 5 years old were identified by the presence of three or more Medicaid claims with a diagnosis of SCA within a calendar year in six states. Receipt of antibiotics was identified through claims for filled prescriptions. The authors conclude that antibiotic prophylaxis rates are low among children with SCA; more healthcare encounters may offer opportunities for increased intervention. Potential predictors were identified as age, sex, year, state, and health services usage.
AHRQ-funded; HS020516.
Citation: Reeves SL, Tribble AC, Madden B .
Antibiotic prophylaxis for children with sickle cell anemia.
Pediatrics 2018 Mar;141(3). doi: 10.1542/peds.2017-2182..
Keywords: Sickle Cell Disease, Children/Adolescents, Antibiotics, Prevention, Pneumonia, Medication
Lewis AH, Chugh A, Sobotka SA
Behavioral outbursts in a child with a deletion syndrome, generalized epilepsy, global developmental delay, and failure to thrive.
This paper presents the case of a 7-year-old girl with 20q13.33 deletion and a history of generalized convulsive epilepsy who presented to the Developmental and Behavioral Pediatrics Clinic due to concerns about her behavioral outbursts in the context of overall delayed development.
AHRQ-funded; HS023007.
Citation: Lewis AH, Chugh A, Sobotka SA .
Behavioral outbursts in a child with a deletion syndrome, generalized epilepsy, global developmental delay, and failure to thrive.
Pediatr Ann 2018 Mar;47(3):e130-e34. doi: 10.3928/19382359-20180223-01..
Keywords: Case Study, Children/Adolescents, Disabilities, Genetics, Neurological Disorders
Rinke ML, Singh H, Heo M
Diagnostic errors in primary care pediatrics: Project RedDE.
The objective of this study was to investigate the frequency of two high-frequency/subacute diagnostic errors (DEs), and one missed opportunity for diagnosis (MOD) in primary care pediatrics. DE or MOD rates in pediatric primary care were found to be 54 percent for patients with elevated BP, 11 percent for patients with abnormal laboratory values, and 62 percent for adolescents with an opportunity to evaluate for depression.
AHRQ-funded; HS022087; HS023608; HS023602.
Citation: Rinke ML, Singh H, Heo M .
Diagnostic errors in primary care pediatrics: Project RedDE.
Acad Pediatr 2018 Mar;18(2):220-27. doi: 10.1016/j.acap.2017.08.005.
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Keywords: Children/Adolescents, Diagnostic Safety and Quality, Medical Errors, Primary Care, Quality Improvement
Leckman-Westin E, Finnerty M, Scholle SH
Differences in Medicaid antipsychotic medication measures among children with SSI, foster care, and income-based aid.
This study examined the application of 6 quality measures for antipsychotic medication prescribing in children and adolescents receiving Medicaid. While indicators of overuse were more common in those with Supplemental Security Income and foster care groups, access to follow-up, metabolic monitoring, and psychosocial services was somewhat better for these children. However, substantial quality shortfalls existed for all groups, particularly metabolic screening and monitoring.
AHRQ-funded; HS020503; HS019937; HS021112.
Citation: Leckman-Westin E, Finnerty M, Scholle SH .
Differences in Medicaid antipsychotic medication measures among children with SSI, foster care, and income-based aid.
J Manag Care Spec Pharm 2018 Mar;24(3):238-46. doi: 10.18553/jmcp.2018.24.3.238.
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Keywords: Children/Adolescents, Medicaid, Medication, Quality Measures, Vulnerable Populations
Gradidge EA, Bakar A, Tellez D
Effect of location on tracheal intubation safety in cardiac disease-are cardiac ICUs safer?
In this retrospective cohort study, the investigators evaluate differences in tracheal intubation-associated events and process variances (i.e., multiple intubation attempts and oxygen desaturation) between pediatric cardiac ICUs and noncardiac PICUs in children with underlying cardiac disease. The authors found that in children with underlying cardiac disease, rates of adverse tracheal intubation-associated events were not lower in cardiac ICUs as compared to noncardiac ICUs, even after adjusting for differences in patient characteristics and care models.
AHRQ-funded; HS024511.
Citation: Gradidge EA, Bakar A, Tellez D .
Effect of location on tracheal intubation safety in cardiac disease-are cardiac ICUs safer?
Pediatr Crit Care Med 2018 Mar;19(3):218-27. doi: 10.1097/pcc.0000000000001422..
Keywords: Adverse Events, Cardiovascular Conditions, Children/Adolescents, Intensive Care Unit (ICU), Patient Safety
Eisler L, Huang G, Lee KM
Identification of perioperative pulmonary aspiration in children using quality assurance and hospital administrative billing data.
This study aims to identify the incidence of and risk factors for perioperative aspiration in children using quality assurance data supplemented by administrative billing records, and to examine the utility of billing data as a supplementary data source. The investigators found that International Classification of Diseases, Ninth Revision codes for aspiration used as a secondary data source were nonspecific for perioperative aspiration, but when combined with record review yielded a 30% increase in identified cases of aspiration over quality assurance data alone.
AHRQ-funded; HS022941.
Citation: Eisler L, Huang G, Lee KM .
Identification of perioperative pulmonary aspiration in children using quality assurance and hospital administrative billing data.
Paediatr Anaesth 2018 Mar;28(3):218-25. doi: 10.1111/pan.13319..
Keywords: Adverse Events, Children/Adolescents, Data, Pneumonia, Respiratory Conditions
Mogul DB, Luo X, Chow EK
Impact of race and ethnicity on outcomes for children waitlisted for pediatric liver transplantation.
This study sought to determine whether outcomes on the waitlist (ie, mortality, deceased donor liver transplantation [DDLT], and living-donor liver transplantation [LDLT]) varied by race/ethnicity. It concluded that, compared to Caucasian children, African-American children are less likely to use LDLT but have higher rates of DDLT and similar survival on the waitlist.
AHRQ-funded; HS024600; HS023876.
Citation: Mogul DB, Luo X, Chow EK .
Impact of race and ethnicity on outcomes for children waitlisted for pediatric liver transplantation.
J Pediatr Gastroenterol Nutr 2018 Mar;66(3):436-41. doi: 10.1097/mpg.0000000000001793.
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Keywords: Children/Adolescents, Healthcare Utilization, Racial and Ethnic Minorities, Outcomes, Transplantation
Shaikh U, Yin HS, Mistry KB
AHRQ Author: Mistry KB
Leveraging medical conferences and webinars for hands-on clinical quality improvement: an intervention to improve health literacy-informed communication in pediatrics.
In this article, the authors describe the process and results with integrating a hands-on quality improvement learning session at the 2016 American Academy of Pediatrics meeting supplemented with virtual peer and expert support through webinars. Their results indicate that this process provided participants with the opportunity to improve clinical care through the use of health literacy–informed communication strategies.
AHRQ-authored.
Citation: Shaikh U, Yin HS, Mistry KB .
Leveraging medical conferences and webinars for hands-on clinical quality improvement: an intervention to improve health literacy-informed communication in pediatrics.
Am J Med Qual 2018 Mar/Apr;33(2):213-15. doi: 10.1177/1062860617719129.
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Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Education: Continuing Medical Education, Health Literacy, Children/Adolescents, Quality Improvement
Bavishi A, Boss E, Shah RK
Outcomes after endoscopic dilation of laryngotracheal stenosis: an analysis of ACS-NSQIP.
Endoscopic management of pediatric subglottic stenosis (SGS) is common, however no multi-institutional studies have assessed its perioperative outcomes. This study examined outcomes after endoscopic dilation of laryngotracheal stenosis. The study found that open airway reconstruction is associated with longer length of stay and increased reintubations and reoperations, suggesting a possible opportunity to improve value in healthcare in the appropriately selected patient. Reoperations and readmissions following endoscopic dilation are more prevalent in children less than one year.
AHRQ-funded; HS022932.
Citation: Bavishi A, Boss E, Shah RK .
Outcomes after endoscopic dilation of laryngotracheal stenosis: an analysis of ACS-NSQIP.
J Clin Outcomes Manag 2018 Mar;25(3):111-16..
Keywords: Children/Adolescents, Patient-Centered Outcomes Research, Quality Improvement, Respiratory Conditions, Surgery
Alexander GL, Olden HA, Troy T
Overweight adolescents and asthma: revealing motivations and challenges with adolescent-provider communication.
This mixed-methods study assessed teens' awareness of the link between weight and asthma management, and perspectives on how medical providers might open a discussion about managing weight. The investigators found that most teens responded favorably to initiating weight loss if it impacted asthma management, valued their provider addressing weight and family participation in weight management efforts.
AHRQ-funded; HS022417.
Citation: Alexander GL, Olden HA, Troy T .
Overweight adolescents and asthma: revealing motivations and challenges with adolescent-provider communication.
J Asthma 2018 Mar;55(3):266-74. doi: 10.1080/02770903.2017.1323921..
Keywords: Asthma, Children/Adolescents, Clinician-Patient Communication, Communication, Obesity, Obesity: Weight Management
Kao LM, Greenhawt MJ, Warren CM
Parental and parent-perceived child interest in clinical trials for food allergen immunotherapy.
This investigation of the motivations and desires of caregivers related to enrolling their child in a clinical trial for food allergen immunotherapy found that the majority of respondents would consider enrolling their child in a trial, irrespective of most patient demographic and disease characteristics. Families earning ≥$100,000/ year reported significantly greater willingness to enroll in a trial.
AHRQ-funded; HS024599.
Citation: Kao LM, Greenhawt MJ, Warren CM .
Parental and parent-perceived child interest in clinical trials for food allergen immunotherapy.
Ann Allergy Asthma Immunol 2018 Mar;120(3):331-33.e1. doi: 10.1016/j.anai.2017.12.012.
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Keywords: Children/Adolescents, Evidence-Based Practice, Patient-Centered Outcomes Research, Research Methodologies
Riley AR, Grennan A, Menousek K
Pediatric primary care psychologists' reported level of integration, billing practices, and reimbursement frequency.
The aim of this study was to investigate the relationships between psychologists' reported billing practices, reimbursement rates, and model of integration in pediatric primary care. Survey results showed a clear pattern of higher integration being associated with greater utilization of health & behavior codes and better reimbursement for consultation activities.
AHRQ-funded; HS022981.
Citation: Riley AR, Grennan A, Menousek K .
Pediatric primary care psychologists' reported level of integration, billing practices, and reimbursement frequency.
Fam Syst Health 2018 Mar;36(1):108-12. doi: 10.1037/fsh0000306..
Keywords: Behavioral Health, Children/Adolescents, Payment, Primary Care, Provider
Sills MR, Macy ML, Kocher KE
Return visit admissions may not indicate quality of emergency department care for children.
The goal of this retrospective analysis was to test the hypothesis that in-hospital outcomes are worse among children admitted during a return ED visit than among those admitted during an index visit. Children who were hospitalized in Florida and New York hospitals during a return visit within 7 days were classified as "ED return admissions" or "readmissions"; in-hospital outcomes for ED return admissions and readmissions were compared to "index admissions without return admission". The results indicate that children who are initially discharged from the ED and then have a return admission had lower severity but similar cost in comparison with children who experienced an index admission without a return admission. The authors conclude that this suggests that ED return visit admissions do not involve worse outcomes than index admissions.
AHRQ-funded; HS024160; HS016418.
Citation: Sills MR, Macy ML, Kocher KE .
Return visit admissions may not indicate quality of emergency department care for children.
Acad Emerg Med 2018 Mar;25(3):283-92. doi: 10.1111/acem.13324..
Keywords: Children/Adolescents, Emergency Department, Hospital Discharge, Hospital Readmissions, Hospitals, Quality of Care, Outcomes
Deans KJ, Minneci PC, Nacion KM
Health care quality measures for children and adolescents in foster care: feasibility testing in electronic records.
The objective of the study is to identify healthcare quality measures for young children and adolescents in foster care and to test whether the data required to calculate these measures can be feasibly extracted and interpreted within an electronic health records or within the Statewide Automated Child Welfare Information System. It found that electronic health records and the Statewide System data frequently lacked important information on foster care youth essential for calculating the measures.
AHRQ-funded; HS020503.
Citation: Deans KJ, Minneci PC, Nacion KM .
Health care quality measures for children and adolescents in foster care: feasibility testing in electronic records.
BMC Pediatr 2018 Feb 22;18(1):79. doi: 10.1186/s12887-018-1064-4.
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Keywords: Children/Adolescents, Electronic Health Records (EHRs), Quality Measures, Vulnerable Populations
Khamash DF, Voskertchian A, Milstone AM
Manipulating the microbiome: evolution of a strategy to prevent S. aureus disease in children.
Hospitalized infants have the highest rates of invasive Staphylococcus aureus disease of any population and infection control strategies such as decolonization have been insufficient. In this article, the authors review what is known about bacterial communities in the nasal cavity of infants and discuss how future microbiome studies may help identify novel interventions to protect high-risk infants from S. aureus disease.
AHRQ-funded; HS022872.
Citation: Khamash DF, Voskertchian A, Milstone AM .
Manipulating the microbiome: evolution of a strategy to prevent S. aureus disease in children.
J Perinatol 2018 Feb;38(2):105-09. doi: 10.1038/jp.2017.155..
Keywords: Healthcare-Associated Infections (HAIs), Infectious Diseases, Children/Adolescents, Prevention, Newborns/Infants, Patient Safety
Aalsma MC, Zerr AM, Etter DJ
Physician intervention to positive depression screens among adolescents in primary care.
The objective of this study was to determine the effectiveness of computer-based screening and physician feedback to guide adolescent depression management within primary care. The investigators found that when a computer-based decision support system algorithm focused on adolescent depression and was implemented in two primary care clinics, a majority of physicians utilized screening results to guide clinical care.
AHRQ-funded; HS022681.
Citation: Aalsma MC, Zerr AM, Etter DJ .
Physician intervention to positive depression screens among adolescents in primary care.
J Adolesc Health 2018 Feb;62(2):212-18. doi: 10.1016/j.jadohealth.2017.08.023..
Keywords: Care Management, Children/Adolescents, Decision Making, Depression, Health Information Technology (HIT), Behavioral Health, Primary Care, Primary Care: Models of Care, Screening
Szilagyi PG, Schaffer S, Rand CM
School-located influenza vaccinations for adolescents: a randomized controlled trial.
In this study, the investigators aimed to evaluate the effect of school-located influenza vaccination (SLIV) on adolescents' influenza vaccination rates. In 2015-2016, they performed a cluster-randomized trial of adolescent SLIV in middle/high schools. They concluded that SLIV in this community increased influenza vaccination rates among adolescents attending suburban schools.
AHRQ-funded; HS021163.
Citation: Szilagyi PG, Schaffer S, Rand CM .
School-located influenza vaccinations for adolescents: a randomized controlled trial.
J Adolesc Health 2018 Feb;62(2):157-63. doi: 10.1016/j.jadohealth.2017.09.021..
Keywords: Children/Adolescents, Education, Influenza, Prevention, Public Health, Vaccination
Etter DJ, McCord A, Ouyang F
Suicide screening in primary care: use of an electronic screener to assess suicidality and improve provider follow-up for adolescents.
The purpose of this study was to assess the feasibility of using an existing computer decision support system to screen adolescent patients for suicidality and provide follow-up guidance to clinicians in a primary care setting. The authors concluded that incorporating adolescent suicide screening and provider follow-up guidance into an existing computer decision support system in primary care was feasible and well utilized by providers.
AHRQ-funded; HS022681.
Citation: Etter DJ, McCord A, Ouyang F .
Suicide screening in primary care: use of an electronic screener to assess suicidality and improve provider follow-up for adolescents.
J Adolesc Health 2018 Feb;62(2):191-97. doi: 10.1016/j.jadohealth.2017.08.026..
Keywords: Children/Adolescents, Clinical Decision Support (CDS), Decision Making, Depression, Behavioral Health, Primary Care, Screening
Hermann LE, Hall M, Kyler K
The pipeline from abstract presentation to publication in pediatric hospital medicine.
The authors of this article identified the publication rate of abstracts submitted to the 2014 Pediatric Hospital Medicine (PHM) conference and determined whether presentation format was associated with subsequent journal publication or time to publication. They found that abstracts accepted for oral presentation had more than 7-fold greater odds of publication and a 4-fold greater likelihood of publication at each month compared with rejected abstracts. Median journal impact factor was significantly higher for oral presentations than for other presentation formats. They concluded that abstract reviewers may be able to identify methodologically sound studies for presentation; however, the low overall publication rate may indicate that presented results are preliminary or signify a need for increased mentorship and resources for research development in PHM.
AHRQ-funded; 2337002T; 233201500016I.
Citation: Hermann LE, Hall M, Kyler K .
The pipeline from abstract presentation to publication in pediatric hospital medicine.
J Hosp Med 2018 Feb;13(2):90-95. doi: 10.12788/jhm.2853..
Keywords: Children/Adolescents, Health Services Research (HSR), Hospitals
Gawel M, Emerson B, Giuliano JS, Jr.,
A qualitative study of multidisciplinary providers' experiences with the transfer process for injured children and ideas for improvement.
The purpose of this study was 1) to explore multidisciplinary providers' experiences with the process of transferring injured children and 2) to describe proposed ideas for process improvement. The authors concluded that efforts to improve the transfer process for injured children should be guided by the experiences of and input from multidisciplinary frontline emergency providers.
AHRQ-funded; HS023554.
Citation: Gawel M, Emerson B, Giuliano JS, Jr., .
A qualitative study of multidisciplinary providers' experiences with the transfer process for injured children and ideas for improvement.
Pediatr Emerg Care 2018 Feb;34(2):125-31. doi: 10.1097/pec.0000000000001405..
Keywords: Children/Adolescents, Patient Safety, Provider, Quality Improvement, Injuries and Wounds
Geis GL, Wheeler DS, Bunger A
A validation argument for a simulation-based training course centered on assessment, recognition, and early management of pediatric sepsis.
The aim of this study was to create a validity argument for the use of a simulation-based training course centered on assessment, recognition, and early management of sepsis in a laboratory-based setting. The authors concluded that, although incomplete, evidence from initial testing suggests that the simulations of pediatric sepsis were sufficiently valid to justify their use in training novice pediatric physicians in the assessment, recognition, and management of pediatric sepsis.
AHRQ-funded; HS020455.
Citation: Geis GL, Wheeler DS, Bunger A .
A validation argument for a simulation-based training course centered on assessment, recognition, and early management of pediatric sepsis.
Simul Healthc 2018 Feb;13(1):16-26. doi: 10.1097/sih.0000000000000271..
Keywords: Children/Adolescents, Diagnostic Safety and Quality, Sepsis, Training
Ireys HT, Brach C, Anglin G
AHRQ Author: Brach C
After the demonstration: what states sustained after the end of federal grants to improve children's health care quality.
As part of the CHIPRA Quality Demonstration Grant Program’s multifaceted evaluation, this study examined the extent to which states sustained key program activities after the demonstration ended. It concluded that as a result of the federal government's investment in this grant program, many demonstration states are in a strong position to extend and spread specific strategies for improving the quality of care for children in Medicaid and CHIP.
AHRQ-authored; AHRQ-funded; 29020090002191.
Citation: Ireys HT, Brach C, Anglin G .
After the demonstration: what states sustained after the end of federal grants to improve children's health care quality.
Matern Child Health J 2018 Feb;22(2):195-203. doi: 10.1007/s10995-017-2391-z.
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Keywords: Children/Adolescents, Children's Health Insurance Program (CHIP), Quality of Care, Health Insurance, Medicaid
Gay JC, Hall M, Markham JL
Association of extending hospital length of stay with reduced pediatric hospital readmissions.
This article describes a retrospective cohort study of hospitalized children (aged 0-18years) using data from 2015 to 2016 from the Pediatric Health Information System database (Children’s Hospital Association), which includes clinical and billing data from 49 children’s hospitals, representing approximately 20% of all US discharges for children.
AHRQ-funded; HS024453.
Citation: Gay JC, Hall M, Markham JL .
Association of extending hospital length of stay with reduced pediatric hospital readmissions.
JAMA Pediatr 2018 Feb;173(2):186-88. doi: 10.1001/jamapediatrics.2018.3815..
Keywords: Children/Adolescents, Hospital Readmissions, Hospitalization
Michelson KA, Hudgins JD, Monuteaux MC
Cardiac arrest survival in pediatric and general emergency departments.
Understanding whether pediatric emergency departments (EDs) have higher survival than general EDs may help identify ways to improve care for all patients with out-of-hospital cardiac arrest (OHCA). Researchers sought to determine if OHCA survival differs between pediatric and general EDs. In their nationally representative sample, survival from nontraumatic OHCA was higher in pediatric EDs than general EDs. Survival did not differ in traumatic OHCA.
AHRQ-funded; HS000063.
Citation: Michelson KA, Hudgins JD, Monuteaux MC .
Cardiac arrest survival in pediatric and general emergency departments.
Pediatrics 2018 Feb;141(2). doi: 10.1542/peds.2017-2741.
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Keywords: Cardiovascular Conditions, Emergency Department, Healthcare Cost and Utilization Project (HCUP), Patient-Centered Outcomes Research, Children/Adolescents
Gowey MA, Chandler-Laney PC
Children's food and satiety responsiveness in association with post-prandial glucose following a standardized liquid meal.
The objective of this study was to examine the association between children's post-prandial glucose responses and maternal report of their eating behaviours. The study’s results suggested that earlier and smaller post-prandial glucose excursions may be related to children's response to food cues.
AHRQ-funded; HS023009.
Citation: Gowey MA, Chandler-Laney PC .
Children's food and satiety responsiveness in association with post-prandial glucose following a standardized liquid meal.
Clin Obes 2018 Feb;8(1):39-42. doi: 10.1111/cob.12210..
Keywords: Children/Adolescents, Nutrition, Obesity