National Healthcare Quality and Disparities Report
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Topics
- Access to Care (1)
- Asthma (3)
- Autism (1)
- Behavioral Health (1)
- Caregiving (1)
- (-) Children/Adolescents (17)
- (-) Chronic Conditions (17)
- Clinician-Patient Communication (1)
- Communication (1)
- Decision Making (2)
- Diabetes (1)
- Diagnostic Safety and Quality (1)
- Disparities (1)
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- Influenza (1)
- Medicaid (1)
- Medical Expenditure Panel Survey (MEPS) (1)
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- Patient-Centered Outcomes Research (1)
- Patient Self-Management (1)
- Policy (1)
- Prevention (2)
- Primary Care (1)
- Primary Care: Models of Care (1)
- Quality of Life (1)
- Respiratory Conditions (1)
- Screening (1)
- Sickle Cell Disease (1)
- Substance Abuse (1)
- Transitions of Care (1)
- Transplantation (1)
- U.S. Preventive Services Task Force (USPSTF) (1)
- Vulnerable Populations (1)
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
1 to 17 of 17 Research Studies DisplayedChou R, Dana T, Fu R
Screening for hepatitis C virus infection in adolescents and adults: updated evidence report and systematic review for the US Preventive Services Task Force.
AHRQ-funded; 290201500009I.
Citation: Chou R, Dana T, Fu R .
Screening for hepatitis C virus infection in adolescents and adults: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2020 Mar 10;323(10):970-75. doi: 10.1001/jama.2019.20788..
Keywords: U.S. Preventive Services Task Force (USPSTF), Children/Adolescents, Hepatitis, Chronic Conditions, Screening, Evidence-Based Practice, Prevention
Volerman A, Fierstein J, Boon K
Factors associated with effective inhaler technique among children with moderate to severe asthma.
Guidelines recommend that children and families receive education about and demonstration of effective inhaler technique as part of asthma self-management education. For youth, improved inhaler technique is associated with better quality of life and decreased health care use, yet technique remains suboptimal. To understand potential reasons for differences in inhaler skills, this study examined individual- and health care-level factors associated with effective inhaler technique among children.
AHRQ-funded; HS026385.
Citation: Volerman A, Fierstein J, Boon K .
Factors associated with effective inhaler technique among children with moderate to severe asthma.
Ann Allergy Asthma Immunol 2019 Nov;123(5):511-12.e1. doi: 10.1016/j.anai.2019.08.017.
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Keywords: Children/Adolescents, Asthma, Chronic Conditions, Patient Self-Management, Education: Patient and Caregiver, Medication, Quality of Life
Goldstein E, Finelli L, O'Halloran A
AHRQ Author: Karaca Z, Steiner C
Hospitalizations associated with respiratory syncytial virus and influenza in children, including children diagnosed with asthma.
This study examined hospitalization rates in children associated with respiratory syncytial virus (RSV) and influenza, including children with asthma. HCUP hospitalization data and additional data to estimate RSV and influenza-associated hospitalization with a respiratory cause was analyzed in different subpopulations of US children between 2003 and 2010. Annual rates of RSV-associated hospitalization was highest in infants and young children, and declined rapidly with age. Influenza hospitalizations also were highest in young children and declined by age 12-17 years. Higher rates of RSV-related and influenza hospitalization in the youngest children with a prior diagnosis of asthma was also found.
AHRQ-authored.
Citation: Goldstein E, Finelli L, O'Halloran A .
Hospitalizations associated with respiratory syncytial virus and influenza in children, including children diagnosed with asthma.
Epidemiology 2019 Nov;30(6):918-26. doi: 10.1097/ede.0000000000001092..
Keywords: Healthcare Cost and Utilization Project (HCUP), Children/Adolescents, Asthma, Influenza, Respiratory Conditions, Hospitalization, Chronic Conditions
Silber JH, Rosenbaum PR, Pimentel SD
Comparing resource use in medical admissions of children with complex chronic conditions.
In this study, the investigators explored whether some hospitals display a significantly different pattern of resource utilization than others when caring for similar children with complex chronic conditions (CCCs) admitted for medical diagnoses. The investigators concluded that hospitals treating similar patients with CCCs admitted for similar medical diagnoses, varied greatly in resource utilization. They suggest that Template Matching can aid chief quality officers benchmarking their hospitals to peer institutions and can help determine types of their patients having the most aberrant outcomes, facilitating quality initiatives to target these patients.
AHRQ-funded; HS020508.
Citation: Silber JH, Rosenbaum PR, Pimentel SD .
Comparing resource use in medical admissions of children with complex chronic conditions.
Med Care 2019 Aug;57(8):615-24. doi: 10.1097/mlr.0000000000001149..
Keywords: Children/Adolescents, Chronic Conditions, Hospitals, Healthcare Utilization, Hospitalization
Auger KA, Shah SS, Huang B
Discharge medical complexity, change in medical complexity and pediatric 30-day readmission.
Investigators conducted a five-year retrospective, case-control study of pediatric hospitalizations at a tertiary care children's hospital and estimated odds of 30-day unplanned readmission using adjusted conditional logistic regression. They found that polypharmacy and use of technology at discharge pose a substantial readmission risk for children, but added technology and new complex chronic conditions do not increase risk when accounting for length of stay.
AHRQ-funded; HS204735.
Citation: Auger KA, Shah SS, Huang B .
Discharge medical complexity, change in medical complexity and pediatric 30-day readmission.
J Hosp Med 2019 Aug;14(8):474-81. doi: 10.12788/jhm.3222..
Keywords: Children/Adolescents, Chronic Conditions, Hospital Readmissions, Hospitalization, Hospitals
Lindly OJ, Zuckerman KE, Kuhlthau KA
Healthcare access and services use among US children with autism spectrum disorder.
This study’s goal was to examine healthcare access and service use among US children with autism spectrum disorder. Data was analyzed from the 2011-2014 National Health Interview Survey data on 651 children with autism spectrum disorder aged 2-17 years. Three measures of healthcare access problems were used: delays accessing healthcare, difficulty affording healthcare, and trouble finding a healthcare provider. Five service measures were used: 4 office visits, 1 well-child visit, flu vaccine, prescription medication, and 1 emergency department visit. Twenty-nine percent of children were found to have had 1 healthcare access problem. This healthcare access problem was associated with lower adjusted odds of 1 well-child visit or prescription medications but higher adjusted odds for 1 emergency department visit or 4 office visits. The association between healthcare access problems and emergency department use were higher for those with higher economic status and White, non-Hispanic subgroups.
AHRQ-funded; HS000063.
Citation: Lindly OJ, Zuckerman KE, Kuhlthau KA .
Healthcare access and services use among US children with autism spectrum disorder.
Autism 2019 Aug;23(6):1419-30. doi: 10.1177/1362361318815237..
Keywords: Children/Adolescents, Autism, Access to Care, Chronic Conditions, Disparities
Ronis SD, Kleinman LC, Stange KC
A learning loop model of collaborative decision-making in chronic illness.
In this article, the authors discuss their learning loop model, which posits the relationship between pediatric patients, their parents, and their clinicians as central to the collaborative decision-making process in the setting of chronic illness. The model incorporates the evolution of both context and developmental capacity over time. It suggests that "meta-learning" from the experience of and outcomes from iterative decision is a key factor that may influence relationships and thus continued engagement in collaboration by patients, their parents, and their clinicians.
AHRQ-funded; HS024433.
Citation: Ronis SD, Kleinman LC, Stange KC .
A learning loop model of collaborative decision-making in chronic illness.
Acad Pediatr 2019 Jul;19(5):497-503. doi: 10.1016/j.acap.2019.04.006..
Keywords: Children/Adolescents, Chronic Conditions, Decision Making, Patient-Centered Healthcare, Primary Care: Models of Care, Primary Care, Clinician-Patient Communication, Communication
Adams JS, Chien AT, Wisk LE
Mental illness among youth with chronic physical conditions.
Using MEPS data, the authors compared the risk of incident mental health conditions (MHCs) in youth with and without chronic physical conditions (CPCs), and explored whether activity limitations might contribute to any association. They found that youth with CPCs have increased risk for MHCs and that limitations on activity may play a role in MHC development. They recommended that youth with CPCs may benefit from services that bolster their ability to participate in developmentally important activities and that may help to detect and treat new onset MHCs.
AHRQ-funded; HS022986.
Citation: Adams JS, Chien AT, Wisk LE .
Mental illness among youth with chronic physical conditions.
Pediatrics 2019 Jul;141(1):pii: e20181819. doi: 10.1542/peds.2018-1819..
Keywords: Children/Adolescents, Chronic Conditions, Medical Expenditure Panel Survey (MEPS), Behavioral Health
Wisk LE, Levy S, Weitzman ER
Parental views on state cannabis laws and marijuana use for their medically vulnerable children.
Given a rapidly changing policy landscape, the investigators sought to characterize the effects of state marijuana laws on parents' views of marijuana use by their teenage children. The investigators found that among parents of medically vulnerable children, perceiving state marijuana policies as more permissive was strongly associated with lower perceived riskiness of marijuana use for their children.
AHRQ-funded; HS022986.
Citation: Wisk LE, Levy S, Weitzman ER .
Parental views on state cannabis laws and marijuana use for their medically vulnerable children.
Drug Alcohol Depend 2019 Jun 1;199:59-67. doi: 10.1016/j.drugalcdep.2018.12.027..
Keywords: Children/Adolescents, Policy, Vulnerable Populations, Chronic Conditions, Substance Abuse
Feinstein JA, Hall M, Antoon JW
Chronic medication use in children insured by Medicaid: a multistate retrospective cohort study.
This retrospective cohort study examined the use of chronic medication (CM) use in children insured by Medicaid. The cohort included children ages 1 to 18 years from 10 states in 2014. It was grouped by the annual number of CMs (0, 1, 2-4, 5-9, and >=10). Of the over 4.5 million subjects, 18.8% used CMs, and 44% in children with a complex chronic condition. The most common CM therapeutic class was neurologic (28.8%). For children prescribed only 1 CM, the most common class is amphetamine stimulants. For children with 10 or greater CMs prescribed, antiepileptics were the most common. Increased CM use was associated with increased hospitalization and emergency department use.
AHRQ-funded; HS025138.
Citation: Feinstein JA, Hall M, Antoon JW .
Chronic medication use in children insured by Medicaid: a multistate retrospective cohort study.
Pediatrics 2019 Apr;143(4). doi: 10.1542/peds.2018-3397..
Keywords: Children/Adolescents, Chronic Conditions, Medicaid, Medication
Crosby LE, Walton A, Shook LM
Development of a hydroxyurea decision aid for parents of children with sickle cell anemia.
This study developed a decision aid for use of hydroxyurea for parents of children with sickle cell anemia. There are national evidence-based guidelines, but they do not offer strategies for implementation. A multicomponent decision aid was developed via a needs assessment, clinic observations and iterative feedback. The decision aid was considered useful by the 75 parents and 28 clinicians who participated in all phases of the study.
AHRQ-funded; HS021114.
Citation: Crosby LE, Walton A, Shook LM .
Development of a hydroxyurea decision aid for parents of children with sickle cell anemia.
J Pediatr Hematol Oncol 2019 Jan;41(1):56-63. doi: 10.1097/mph.0000000000001257..
Keywords: Caregiving, Children/Adolescents, Chronic Conditions, Decision Making, Education: Patient and Caregiver, Medication, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Sickle Cell Disease
Davis AM, Brown RF, Taylor JL
Transition care for children with special health care needs.
This article examined 25 studies evaluating transition care programs for children with special health care needs moving from pediatric to adult care. The majority of studies concerned patients with diabetes or transplant patients.The authors also interviewed key informants representing clinicians who provide transition care. They found that there is no accepted way to measure transition success.
AHRQ-funded; 290201200009I
Citation: Davis AM, Brown RF, Taylor JL .
Transition care for children with special health care needs.
Pediatrics. 2014 Nov;134(5):900-8. doi: 10.1542/peds.2014-1909..
Keywords: Children/Adolescents, Transitions of Care, Chronic Conditions
Feudtner C, Feinstein JA, Zhong W
Pediatric complex chronic conditions classification system version 2: updated for ICD-10 and complex medical technology dependence and transplantation.
In order to update the pediatric complex chronic conditions (CCC) classification system, the authors incorporated ICD-9 diagnostic codes that had been either omitted or incorrectly specified in the original system, and then translated between ICD-9 and ICD-10 using General Equivalence Mappings (GEMs). They concluded that the updated CCC version 2 system is comprehensive and multidimensional, providing a necessary update to accommodate widespread implementation of ICD-10.
AHRQ-funded; HS018425.
Citation: Feudtner C, Feinstein JA, Zhong W .
Pediatric complex chronic conditions classification system version 2: updated for ICD-10 and complex medical technology dependence and transplantation.
BMC Pediatr 2014 Aug 8;14:199. doi: 10.1186/1471-2431-14-199.
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Keywords: Children/Adolescents, Chronic Conditions, Transplantation
Forrest CB, Margolis PA, Bailey LC
PEDSnet: a National Pediatric Learning Health System.
The authors describe a National Pediatric Learning Health System (NPLHS) that is being implemented by PEDSnet, a clinical data research network. The NPLHS will consist of a flexible dual data architecture that incorporates two widely used data models and national terminology standards to support multi-institutional data integration, cohort discovery, and advanced analytics that enable rapid learning.
AHRQ-funded; HS022974; HS019912
Citation: Forrest CB, Margolis PA, Bailey LC .
PEDSnet: a National Pediatric Learning Health System.
J Am Med Inform Assoc. 2014 Jul-Aug;21(4):602-6. doi: 10.1136/amiajnl-2014-002743..
Keywords: Children/Adolescents, Health Information Technology (HIT), Chronic Conditions
Forrest CB, Margolis P, Seid M
PEDSnet: how a prototype pediatric learning health system is being expanded into a national network.
The authors describe a National Pediatric Learning Health System (NPLHS) that is being implemented by PEDSnet, a clinical data research network. The NPLHS will consist of a flexible dual data architecture that incorporates two widely used data models and national terminology standards to support multi-institutional data integration, cohort discovery, and advanced analytics that enable rapid learning.
AHRQ-funded; HS020024
Citation: Forrest CB, Margolis P, Seid M .
PEDSnet: how a prototype pediatric learning health system is being expanded into a national network.
Health Aff. 2014 Jul;33(7):1171-7. doi: 10.1377/hlthaff.2014.0127..
Keywords: Children/Adolescents, Health Information Technology (HIT), Chronic Conditions
Jackson DJ, Hartert TV, Martinez FD
Asthma: NHLBI workshop on the primary prevention of chronic lung diseases.
This article reports on the state of primary prevention research in asthma, with emphasis on specific recommendations for research priorities and interventions that could be undertaken now. The emphasis of this work was on prevention of disease onset, and because the majority of asthma begins during preschool years, this document focuses on childhood asthma.
AHRQ-funded; HS018454, HS022093
Citation: Jackson DJ, Hartert TV, Martinez FD .
Asthma: NHLBI workshop on the primary prevention of chronic lung diseases.
Ann Am Thorac Soc. 2014 Apr;11 Suppl 3:S139-45. doi: 10.1513/AnnalsATS.201312-448LD..
Keywords: Asthma, Prevention, Children/Adolescents, Chronic Conditions
Lawrence JM, Black MH, Zhang JL
Validation of pediatric diabetes case identification approaches for diagnosed cases by using information in the electronic health records of a large integrated managed health care organization.
The researchers explored the utility of different algorithms for diabetes case identification by using electronic health records. They found that case identification accuracy was highest in 75% of bootstrapped samples for those who had 1 or more outpatient diabetes diagnoses or 1 or more insulin prescriptions and in 25% of samples for those who had 2 or more outpatient diabetes diagnoses and 1 or more antidiabetic medications.
AHRQ-funded; HS019859.
Citation: Lawrence JM, Black MH, Zhang JL .
Validation of pediatric diabetes case identification approaches for diagnosed cases by using information in the electronic health records of a large integrated managed health care organization.
Am J Epidemiol 2014 Jan;179(1):27-38. doi: 10.1093/aje/kwt230..
Keywords: Children/Adolescents, Diabetes, Chronic Conditions, Electronic Health Records (EHRs), Health Information Technology (HIT), Diagnostic Safety and Quality