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
26 to 50 of 245 Research Studies DisplayedLeary JC, Walsh KE, Morin RA
Quality and safety of pediatric inpatient care in community hospitals: a scoping review.
This study’s aim was to conduct a scoping review and synthesize literature on the quality and safety of pediatric inpatient care in nonpediatric hospitals in the United States. A systematic literature review was performed in October 2016 to identify pediatric studies that reported on safety, effectiveness, efficiency, timeliness, patient-centeredness, or equity set. A total of 44 articles were included using inclusion criteria. There was a moderate or high risk of bias for 72% of the studies. This study shows there is very limited research currently and would benefit from more multicenter collaborations.
AHRQ-funded; HS024133.
Citation: Leary JC, Walsh KE, Morin RA .
Quality and safety of pediatric inpatient care in community hospitals: a scoping review.
J Hosp Med 2019 Nov 1;14(10):694-703. doi: 10.12788/jhm.3268..
Keywords: Patient-Centered Outcomes Research, Evidence-Based Practice, Children/Adolescents, Inpatient Care, Hospitals, Patient Safety, Quality of Care
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.
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
Gray DT, Mizrahi T
AHRQ Author: Gray DT, Mizrahi T
Trends in appendicitis and perforated appendicitis prevalence in children in the United States, 2001-2015,
This cross-sectional study examined trends in appendicitis and perforated appendicitis in children in the United States from 2001 to 2015 using State Inpatient Databases (SIDS) HCUP data. Investigators found that rates of perforated appendicitis rose during that time period.
AHRQ-authored.
Citation: Gray DT, Mizrahi T .
Trends in appendicitis and perforated appendicitis prevalence in children in the United States, 2001-2015,
JAMA Netw Open 2020 Oct;3(10):e2023484. doi: 10.1001/jamanetworkopen.2020.23484..
Keywords: Healthcare Cost and Utilization Project (HCUP), Children/Adolescents, Diagnostic Safety and Quality
Zullo AR, Adams JW, Gantenberg JR
Examining neighborhood poverty-based disparities in HIV/STI prevalence: an analysis of Add Health data.
The purpose of the study was to estimate the effect of exposure to neighborhood poverty in adolescence on HIV/STI prevalence in early adulthood. The investigators found that strong evidence for neighborhood poverty-based differences in HIV/STI prevalence was not observed. They suggest that researchers should continue to investigate the effect of neighborhood-level socioeconomic position measures and, if warranted, identify etiologically relevant exposure periods.
AHRQ-funded; HS022998.
Citation: Zullo AR, Adams JW, Gantenberg JR .
Examining neighborhood poverty-based disparities in HIV/STI prevalence: an analysis of Add Health data.
Ann Epidemiol 2019 Nov;39:8-14.e4. doi: 10.1016/j.annepidem.2019.09.010..
Keywords: Children/Adolescents, Low-Income, Vulnerable Populations, Disparities, Social Determinants of Health, Human Immunodeficiency Virus (HIV), Infectious Diseases, Young Adults, Health Status
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
Rawlett KE, N'Dri LA, dosReis S
Perceived needs for adolescent mental health in an urban community.
This paper discusses a set of focus groups that were conducted with teachers, families, and students in an urban middle school to discuss needs for adolescent psychological well-being. Six focus groups were conducted with a total of 29 participants. Approximately 70% of participants were female, African American (n=22), and the rest were multiracial (n=4), White (n=2) and Latino (n=1). Participants focused on needs for educational support, strengthening social skills, and changing the community landscape.
AHRQ-funded; HS022135.
Citation: Rawlett KE, N'Dri LA, dosReis S .
Perceived needs for adolescent mental health in an urban community.
J Pediatr Health Care 2019 Nov - Dec;33(6):633-38. doi: 10.1016/j.pedhc.2019.03.003..
Keywords: Children/Adolescents, Behavioral Health, Urban Health
Luo X, Mogul DB, Massie AB
Predicting chance of liver transplantation for pediatric wait-list candidates.
The authors sought to predict the chance of receiving a deceased donor liver transplant (DDLT) for pediatric patients. Their model accurately predicted chance of transplant and was able to predict DDLT at specific follow-up times. They conclude that their model can serve as the basis for an online tool that would provide useful information for pediatric wait-list candidates.
AHRQ-funded; HS023876.
Citation: Luo X, Mogul DB, Massie AB .
Predicting chance of liver transplantation for pediatric wait-list candidates.
Pediatr Transplant 2019 Nov;23(7):e13542. doi: 10.1111/petr.13542..
Keywords: Children/Adolescents, Transplantation, Healthcare Delivery, Access to Care
Olin S, Storfer-Isser A, Morden E
Quality measures for managing prescription of antipsychotic medication among youths: factors associated with health plan performance.
This study examined the performance of health plans on two Healthcare Effectiveness Data and Information Set (HEDIS) measures: metabolic monitoring of children and adolescents prescribed an antipsychotic and use of first-line psychosocial care for children and adolescents prescribed an antipsychotic for a nonindicated use. This study then identified key plan characteristics and other contextual factors associated with health plan performance on quality measures related to pediatric antipsychotic prescribing. Findings suggested that quality measures, in conjunction with policies such as prior authorization, can encourage better care delivery to vulnerable populations.
ARHQ-funded; HS020503; HS025296.
Citation: Olin S, Storfer-Isser A, Morden E .
Quality measures for managing prescription of antipsychotic medication among youths: factors associated with health plan performance.
Psychiatr Serv 2019 Nov;70(11):1020-26. doi: 10.1176/appi.ps.201900089..
Keywords: Children/Adolescents, Medication, Behavioral Health, Quality Measures, Quality of Care, Health Insurance
Cheng TL, Mistry KB
AHRQ Author: Mistry KB
The uniqueness and importance of children in addressing health disparities across the life course: implications for research.
Unfortunately, large racial/ethnic and socioeconomic health and healthcare disparities still exist. This commentary suggests a framework to clarify the research and interventions needed to eliminate health disparities starting early in the life course.
AHRQ-authored.
Citation: Cheng TL, Mistry KB .
The uniqueness and importance of children in addressing health disparities across the life course: implications for research.
Epidemiology 2019 Nov;30(Suppl 2):S60-S64. doi: 10.1097/ede.0000000000001069..
Keywords: Children/Adolescents, Disparities
Nguyen N, Lavery WJ, Capocelli KE, N, Lavery WJ, Capocelli
Transnasal endoscopy in unsedated children with eosinophilic esophagitis using virtual reality video goggles.
Evaluation and treatment of children with eosinophilic esophagitis (EoE) requires serial endoscopic, visual, and histologic assessment by sedated esophagogastroduodenoscopy (EGD). Unsedated transnasal endoscopy (TNE) was reported to be successful in a pilot study of children. In this study, the investigators evaluated video goggle and virtual reality-based unsedated TNE in children with EoE, collecting data on rates of completion, adverse events, and adequacy of visual and histologic findings.
AHRQ-funded; HS024599.
Citation: Nguyen N, Lavery WJ, Capocelli KE, N, Lavery WJ, Capocelli .
Transnasal endoscopy in unsedated children with eosinophilic esophagitis using virtual reality video goggles.
Clin Gastroenterol Hepatol 2019 Nov;17(12):2455-62. doi: 10.1016/j.cgh.2019.01.023..
Keywords: Children/Adolescents, Digestive Disease and Health, Care Management
Goswami E, Ogden RK, Bennett WE
Evidence-based development of a nephrotoxic medication list to screen for acute kidney injury risk in hospitalized children.
This paper describes an initiative to develop an evidence-based list of nephrotoxic medications to screen for acute kidney injury (AKI) risk in hospitalized children. This initiative, called the Nephrotoxic Injury Negated by Just-in-time Action quality improvement collaborative, convened a Nephrotoxic Medication (NTMx) Subcommittee composed of pediatric nephrologists, a pharmacist, and a pediatric intensivist. The committee reviewed NTMx lists, conducted a literature review of the disputed medications, and assigned an evidence grade based on the association between nephrotoxicity and the quality of the data. The subcommittee then came to a majority consensus to which medications should be included on the list. The list was presented to the larger collaborative and voted on. This list will be continually updated and voted on annually.
AHRQ-funded; HS023763.
Citation: Goswami E, Ogden RK, Bennett WE .
Evidence-based development of a nephrotoxic medication list to screen for acute kidney injury risk in hospitalized children.
Am J Health Syst Pharm 2019 Oct 30;76(22):1869-74. doi: 10.1093/ajhp/zxz203..
Keywords: Children/Adolescents, Medication: Safety, Medication, Patient Safety, Risk, Evidence-Based Practice, Adverse Drug Events (ADE), Adverse Events
Bardach NS, Neel C, Kleinman LC
Depression, anxiety, and emergency department use for asthma.
This study examined whether pediatric patients with asthma who use the emergency department (ED) experience increased depression and anxiety in the same way that adult asthma patients do. Out of 65,342 patients identified from the Massachusetts All-Payer Claims Database for 2014 to 2015 who had ED visits, 24.7% had a diagnosis of anxiety, depression, or both. Asthma rates were shown to be higher than those of patients who had no diagnosis of anxiety or depression.
AHRQ-funded; HS025297; HS020518.
Citation: Bardach NS, Neel C, Kleinman LC .
Depression, anxiety, and emergency department use for asthma.
Pediatrics 2019 Oct;144(4). doi: 10.1542/peds.2019-0856..
Keywords: Asthma, Depression, Anxiety, Children/Adolescents, Emergency Department, Behavioral Health
Mogul DB, Fredericks EM, Brady TM
Digital wings: innovations in transition readiness for adolescent and young adult transplant recipients.
This article reports on two multi-stakeholder symposia organized by The Johns Hopkins University School of Medicine on February 2, 2018, and January 11, 2019, to address the problem of high graft failure in adolescent and young adult solid organ transplant recipients. Additionally, data collected from recipients demonstrated a substantial gap in how this population uses technologies for health-related activities, alongside an increased interest in an app to help them manage their transplant.
AHRQ-funded; HS023876.
Citation: Mogul DB, Fredericks EM, Brady TM .
Digital wings: innovations in transition readiness for adolescent and young adult transplant recipients.
Transplantation 2019 Oct;103(10):1970-74. doi: 10.1097/tp.0000000000002749..
Keywords: Transplantation, Children/Adolescents, Young Adults, Surgery, Patient-Centered Outcomes Research, Evidence-Based Practice
Shenkman E, Tomar S, Manning D
Feasibility and usability of measuring receipt of sealants in 2 states.
In this study, the authors examined the reliability and validity of the Dental Quality Alliance childhood sealant measure under actual use conditions in Texas and Florida. The 2 states provide care for almost 20% of children in Medicaid nationally. They proposed eliminating the caries risk assessment requirement and incorporating a 3-year look-back period to identify already sealed, missing, or restored molars.
AHRQ-funded; U18 HS025298.
Citation: Shenkman E, Tomar S, Manning D .
Feasibility and usability of measuring receipt of sealants in 2 states.
J Am Dent Assoc 2019 Oct;150(10):839-45. doi: 10.1016/j.adaj.2019.05.022..
Keywords: Dental and Oral Health, Children/Adolescents, Quality Measures, Quality of Care
Choe AY, Unaka NI, Schondelmeyer AC
Inpatient communication barriers and drivers when caring for limited english proficiency children.
The authors identified barriers to and drivers of effective interpreter service use when caring for hospitalized limited English proficiency (LEP) children from the perspectives of pediatric medical providers and interpreters. Using Group Level Assessment, they found that participants identified unique barriers and drivers that impact communication with LEP patients and their families during hospitalization. They suggested that future directions include exploring the perspective of LEP families and utilizing team-based and family-centered communication strategies to standardize and improve communication practices.
AHRQ-funded; HS025138.
Citation: Choe AY, Unaka NI, Schondelmeyer AC .
Inpatient communication barriers and drivers when caring for limited english proficiency children.
J Hosp Med 2019 Oct;14(10):607-13. doi: 10.12788/jhm.3240..
Keywords: Clinician-Patient Communication, Communication, Cultural Competence, Children/Adolescents, Inpatient Care, Patient and Family Engagement, Caregiving
Garrity B, Berry Crofton, C
Parent-to-parent advice on considering spinal fusion in children with neuromuscular scoliosis.
The purpose of this study was to convey advice from families whose children recently underwent spinal fusion to families whose children are under consideration for initial spinal fusion for neuromuscular scoliosis and to providers who counsel families on this decision. Results showed that parents of children who had recently undergone spinal fusion had strong perceptions about what information to convey to families considering surgery, which may improve communication between future parents and physicians. Further investigation is needed to assess how best to incorporate the wisdom and experiences of parent peers into shared decisionmaking and preparation for spinal fusion in children with neuromuscular scoliosis.
AHRQ-funded; HS024453.
Citation: Garrity B, Berry Crofton, C .
Parent-to-parent advice on considering spinal fusion in children with neuromuscular scoliosis.
J Pediatr 2019 Oct;213:149-54. doi: 10.1016/j.jpeds.2019.05.055..
Keywords: Decision Making, Patient and Family Engagement, Caregiving, Children/Adolescents, Back Health and Pain, Surgery
Adrian M, McCauley E, Berk MS
Predictors and moderators of recurring self-harm in adolescents participating in a comparative treatment trial of psychological interventions.
This study compared outcomes for treatment of adolescents who have engaged in self-harm including suicide attempts and nonsuicidal self-injury. This randomized controlled tiral compared results with dialectical behavior therapy (DBT) to treatment with individual/group supportive therapy (IGST). 173 adolescents were randomized to receive 6 months of DBT or IGST. Assessments were made at baseline, midtreatment (3 months), and end of treatment at 6 months using the Suicide Attempt and Self –Injury Interview. Overall, DBT showed better rates of improvement than IGST. These was especially true of adolescents with higher levels of emotion dysregulation and parental psychopathology.
AHRQ-funded; HS022982.
Citation: Adrian M, McCauley E, Berk MS .
Predictors and moderators of recurring self-harm in adolescents participating in a comparative treatment trial of psychological interventions.
J Child Psychol Psychiatry 2019 Oct;60(10):1123-32. doi: 10.1111/jcpp.13099..
Keywords: Children/Adolescents, Behavioral Health, Comparative Effectiveness, Evidence-Based Practice, Patient-Centered Outcomes Research, Family Health and History, Outcomes
Auger KA, Harris JM, Gay JC
Progress (?) toward reducing pediatric readmissions.
Investigators sought to determine if pediatric readmission rates have changed over time. Using data from the Inpatient Essentials Database, they found that both all-cause and potentially preventable readmission rates have remained unchanged over six years in spite of significant national efforts to reduce pediatric readmissions.
AHRQ-funded; HS024735.
Citation: Auger KA, Harris JM, Gay JC .
Progress (?) toward reducing pediatric readmissions.
J Hosp Med 2019 Oct;14(10):618-21. doi: 10.12788/jhm.3210..
Keywords: Children/Adolescents, Hospital Readmissions, Hospitals
Adrian M, Zeman J, Erdley C
Trajectories of non-suicidal self-injury in adolescent girls following inpatient hospitalization.
This study explored the growth of non-suicidal self-injury (NSSI) frequency over 2.5 years in a clinical sample of adolescent girls. The investigators concluded that their findings highlighted the stable nature of NSSI and the contribution of emotion dysregulation and internalizing symptoms to NSSI patterns. The investigators asserted that developing interventions targeting these NSSI predictors early in girls' development may prevent the emergence and maintenance of NSSI.
AHRQ-funded; HS022982.
Citation: Adrian M, Zeman J, Erdley C .
Trajectories of non-suicidal self-injury in adolescent girls following inpatient hospitalization.
Clin Child Psychol Psychiatry 2019 Oct;24(4):831-46. doi: 10.1177/1359104519839732..
Keywords: Children/Adolescents, Evidence-Based Practice, Behavioral Health, Outcomes, Patient-Centered Outcomes Research
Sobotka SA, Lynch E, Quinn MT
Unmet respite needs of children with medical technology dependence.
Children with medical technology dependency (MTD) require a medical device to compensate for a vital body function and substantial nursing care. As such, they require constant high-level supervision. Respite care provides caregivers with a temporary break, and is associated with reduced stress; however, there are often barriers. The study utilizes mixed methodology with the National Survey of Children with Special Health Care Needs (NS-CSHCN) and semistructured interviews with state-wide care coordinators to understand the gap for respite care services.
AHRQ-funded; HS023007.
Citation: Sobotka SA, Lynch E, Quinn MT .
Unmet respite needs of children with medical technology dependence.
Clin Pediatr 2019 Oct;58(11-12):1175-86. doi: 10.1177/0009922819870251..
Keywords: Children/Adolescents, Medical Devices, Disabilities, Caregiving, Home Healthcare, Care Coordination
Kemmick Pintor J, Call KT
State-level immigrant prenatal health care policy and inequities in health insurance among children in mixed-status families.
Investigators sought to measure differences in insurance by mother's documentation status among a nationally representative sample of US-born children in immigrant families and to examine the role of state-level immigrant access to prenatal coverage. They found that, in states with nonrestrictive prenatal coverage for immigrants, there were no differences in children's insurance by mother's documentation status, while large inequities were observed within states with restrictive policies.
AHRQ-funded; HS021973.
Citation: Kemmick Pintor J, Call KT .
State-level immigrant prenatal health care policy and inequities in health insurance among children in mixed-status families.
Glob Pediatr Health 2019 Sep 26;6:2333794x19873535. doi: 10.1177/2333794x19873535..
Keywords: Policy, Health Insurance, Children/Adolescents, Access to Care, Vulnerable Populations, Disparities
Khamash DF, Voskertchian A, Tamma PD
Increasing clindamycin and trimethoprim-sulfamethoxazole resistance in pediatric Staphylococcus aureus Infections.
This retrospective observational study looked at pediatric clinical cultures between 2005 and 2017 that grew Staphylococcus aureus culture and their trends in antibiotic resistance. Methicillin resistance declined but clindamycin and trimethoprim-sulfamethoxazole resistance increased significantly.
AHRQ-funded; HS022872.
Citation: Khamash DF, Voskertchian A, Tamma PD .
Increasing clindamycin and trimethoprim-sulfamethoxazole resistance in pediatric Staphylococcus aureus Infections.
J Pediatric Infect Dis Soc 2019 Sep 25;8(4):351-53. doi: 10.1093/jpids/piy062..
Keywords: Children/Adolescents, Antibiotics, Medication, Healthcare-Associated Infections (HAIs), Infectious Diseases, Methicillin-Resistant Staphylococcus aureus (MRSA)
Merritt C, Dietrich AM, Bogie AL
2018 Academic Emergency Medicine Consensus Conference: A Workforce Development Research Agenda for Pediatric Care in the Emergency Department.
Although the number of pediatric emergency medicine specialists continues to rise, the vast majority of children are cared for in general EDs outside of children's hospitals by a diverse workforce of care providers who must possess the knowledge, experience, skills, and systemic support necessary to deliver excellent pediatric emergency care. There is a crucial need to understand the factors that drive the professional development and support systems of this diverse workforce. In this paper the investigators identified five key research themes and prioritized a specific research agenda.
AHRQ-funded; HS026101.
Citation: Merritt C, Dietrich AM, Bogie AL .
2018 Academic Emergency Medicine Consensus Conference: A Workforce Development Research Agenda for Pediatric Care in the Emergency Department.
Acad Emerg Med 2019 Sep;26(9):1063-73. doi: 10.1111/acem.13638..
Keywords: Emergency Department, Research Methodologies, Children/Adolescents
Montalbano A, Quinonez RA, Hall M
Achievable benchmarks of care for pediatric readmissions.
This study’s objective was to calculate mean readmission rates and the Achievable Benchmarks of Care (ABCs) for pediatric diagnoses by different hospital types: metropolitan teaching, metropolitan nonteaching, and nonmetropolitan hospitals. The authors used a cross-sectional retrospective study of 30-day, all-cause same-hospital readmission of patients less than 18 years of age using the 2014 HCUP National Readmission Database. They calculated mean readmission and corresponding ABCs for the 17 most common readmission diagnosis. They found that sickle cell disease (SCD), bipolar and major depressive disorders were the most common reasons for readmission.
AHRQ-funded; HS024554.
Citation: Montalbano A, Quinonez RA, Hall M .
Achievable benchmarks of care for pediatric readmissions.
J Hosp Med 2019 Sep;14(9):534-40. doi: 10.12788/jhm.3201..
Keywords: Healthcare Cost and Utilization Project (HCUP), Children/Adolescents, Hospital Readmissions, Hospitals, Quality of Care