National Healthcare Quality and Disparities Report
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Search All Research Studies
Topics
- Ambulatory Care and Surgery (1)
- Asthma (3)
- Care Coordination (1)
- (-) Care Management (9)
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- Decision Making (1)
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- Respiratory Conditions (3)
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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
1 to 9 of 9 Research Studies DisplayedSantosa KB, Keane AM, Keller M
Inpatient versus outpatient management of negative pressure wound therapy in pediatric patients.
Negative pressure wound therapy (NPWT) is commonly used to manage complex wounds in the pediatric population. With recently developed portable NPWT devices, providers have the opportunity to transition NPWT to the outpatient setting. However, there are no studies describing outpatient NPWT in pediatric patients. Therefore, the purpose of this study was to leverage a population-level analysis to advance current knowledge about outpatient NPWT use in pediatric patients.
AHRQ-funded; HS019455.
Citation: Santosa KB, Keane AM, Keller M .
Inpatient versus outpatient management of negative pressure wound therapy in pediatric patients.
J Surg Res 2020 Oct;254:197-205. doi: 10.1016/j.jss.2020.04.025..
Keywords: Children/Adolescents, Injuries and Wounds, Treatments, Care Management, Ambulatory Care and Surgery, Hospitalization
Berry JG, Glaspy T, Eagan B
Pediatric complex care and surgery comanagement: preparation for spinal fusion.
This study assessed the impact of preoperative comanagement with complex care pediatricians (CCP) on children with neuromuscular scoliosis undergoing spinal fusion surgery. A chart review of 79 children aged 5-21 years undergoing spinal fusion Jan. 2014-June 2016 was conducted at a children’s hospital. Cerebral palsy (64%) was the most common neuromuscular condition with the mean age of surgery of 14 years. Thirty-nine children had a preoperative CCP evaluation a median 63 days before the preanesthesia visit. More organ systems were affected by coexisting conditions in children with CCP evaluation than those without an evaluation. The rate of last-minute care coordination activities required for surgical clearance as well as last-minute development of new preoperative plans were lower for children with CCP evaluation than those without.
AHRQ-funded; HS024453.
Citation: Berry JG, Glaspy T, Eagan B .
Pediatric complex care and surgery comanagement: preparation for spinal fusion.
J Child Health Care 2020 Sep;24(3):402-10. doi: 10.1177/1367493519864741..
Keywords: Children/Adolescents, Surgery, Care Management, Care Coordination
Cotter JM, Tyler A, Reese J
Steroid variability in pediatric inpatient asthmatics: survey on provider preferences of dexamethasone versus prednisone.
This study looked at pediatric emergency department (ED) inpatient use of dexamethasone versus prednisone by providers for asthma treatment. A survey was distributed to providers who care for inpatient asthmatics. Ninety-two providers completed the survey. When patients received dexamethasone in the ED, 44% continued dexamethasone, 14% switched to prednisone, 2% stopped steroid use, and 40% said it depended on the circumstances. Hospitalists were significantly more likely to continue dexamethasone than pulmonologists (61% versus 15%). Switching to prednisone included factors such as severity of exacerbation (73%) and asthma history (47%). Just over half of providers (5f1%) felt uncomfortable using dexamethasone because of “minimal data to support [its] use inpatient.”
AHRQ-funded; HS026512.
Citation: Cotter JM, Tyler A, Reese J .
Steroid variability in pediatric inpatient asthmatics: survey on provider preferences of dexamethasone versus prednisone.
J Asthma 2020 Sep;57(9):942-48. doi: 10.1080/02770903.2019.1622713..
Keywords: Children/Adolescents, Asthma, Respiratory Conditions, Medication, Inpatient Care, Care Management, Hospitalization, Emergency Department, Practice Patterns, Provider: Physician, Provider
Kaiser SV, Johnson MD, Walls TA
Pathways to improve pediatric asthma care: a multisite, national study of emergency department asthma pathway implementation.
This quality improvement study’s aim was to determine the effects of pediatric asthma pathway implementation in a diverse, national sample of emergency departments (EDs). Desired outcomes included systemic corticosteroid administration within 60 minutes (primary), assessment of severity at ED triage, chest radiograph use, hospital admission or transfer for higher level of care, and ED length of stay. Charts were reviewed each month by EDs for children ages 2-17 years with a primary diagnosis of asthma. A total of 83 EDs were enrolled, with 37 of them children’s hospitals, and 46 community hospitals. Seventy-three percent completed the study (n = 22,963). There was a significant increase in systematic corticosteroid administration within 60 minutes of arrival as well as increased odds of severity assessment at triage and decreased rate of change in odds of hospital admission/transfer. Chest radiograph or ED length of stay was not associated with pathway implementation.
AHRQ-funded; HS024592.
Citation: Kaiser SV, Johnson MD, Walls TA .
Pathways to improve pediatric asthma care: a multisite, national study of emergency department asthma pathway implementation.
J Pediatr 2020 Aug;223:100-07.e2. doi: 10.1016/j.jpeds.2020.02.080..
Keywords: Children/Adolescents, Emergency Department, Asthma, Quality Improvement, Quality of Care, Care Management, Healthcare Delivery, Patient-Centered Outcomes Research, Evidence-Based Practice, Outcomes
Fishbein AB, Hamideh N, Lor J
Management of atopic dermatitis in children younger than two years of age by community pediatricians: a survey and chart review.
The authors characterized primary care providers' (PCPs) practice patterns for atopic dermatitis (AD) in children under 2 years of age and determined the need for AD guidelines for PCPs focused on this age group. They found that PCP management of AD in children under 2 years of age is different from that of older children, with possible underuse of medium/high-potency topical corticosteroids. They recommended clear guidelines for this age group.
AHRQ-funded; HS023011.
Citation: Fishbein AB, Hamideh N, Lor J .
Management of atopic dermatitis in children younger than two years of age by community pediatricians: a survey and chart review.
J Pediatr 2020 Jun;221:138-44.e3. doi: 10.1016/j.jpeds.2020.02.015..
Keywords: Children/Adolescents, Skin Conditions, Provider: Physician, Practice Patterns, Primary Care, Medication, Care Management
Kaiser SV, Jennings B, Rodean J
Pathways for improving inpatient pediatric asthma care (PIPA): a multicenter, national study.
This study examined whether implementation of a pathway strategy for inpatient pediatric asthma patients improve outcomes for these patients. Outcomes measured included length of stay (LOS), early administration of metered-dose inhalers, screening for secondhand tobacco exposure and referral to cessation resources, and 7-day hospital readmissions or emergency revisits. Eighty-five hospitals were enrolled and 68 completed the study with (n=12,013) admissions. Pathways were associated with increases in early administration of metered-dose inhalers, and referral to smoking cessation resources, but no statistically significant changes in the other outcomes were observed. Most hospitals did improve in at least one outcome.
AHRQ-funded; HS024592; HS024554.
Citation: Kaiser SV, Jennings B, Rodean J .
Pathways for improving inpatient pediatric asthma care (PIPA): a multicenter, national study.
Pediatrics 2020 Jun;145(6):e20193026. doi: 10.1542/peds.2019-3026..
Keywords: Children/Adolescents, Asthma, Respiratory Conditions, Inpatient Care, Patient-Centered Outcomes Research, Outcomes, Hospitalization, Care Management
Bonafide CP, Xiao R, Brady PW
Prevalence of continuous pulse oximetry monitoring in hospitalized children with bronchiolitis not requiring supplemental oxygen.
This study examined the use of continuous pulse oximetry monitoring in hospitalized children with bronchiolitis who do not require supplemental oxygen. US national guidelines discourage the use but the practice was found to be still fairly widespread. The researchers conducted a multicenter, cross-sectional study of pediatric wards in 56 US and Canadian hospitals in the Pediatric Research in Inpatient Settings Network from December 2018 through March 2019. Patients aged 8 weeks through 23 months were included as a convenience sample. Overall usage was found to be 46% ranging from 6% to 82%.
AHRQ-funded; HS026763.
Citation: Bonafide CP, Xiao R, Brady PW .
Prevalence of continuous pulse oximetry monitoring in hospitalized children with bronchiolitis not requiring supplemental oxygen.
JAMA 2020 Apr 21;323(15):1467-77. doi: 10.1001/jama.2020.2998..
Keywords: Children/Adolescents, Respiratory Conditions, Inpatient Care, Hospitalization, Care Management, Evidence-Based Practice
Barry-Menkhaus SA, Wagner DV, Riley AR
Small interventions for big change: brief strategies for distress and self-management amongst youth with type 1 diabetes.
In this article, the authors review existing evidence for brief interventions, describe several untested clinical strategies, and make recommendations for accelerating the translational study of brief interventions among youth with type 1 diabetes.
AHRQ-funded; HS022981.
Citation: Barry-Menkhaus SA, Wagner DV, Riley AR .
Small interventions for big change: brief strategies for distress and self-management amongst youth with type 1 diabetes.
Curr Diab Rep 2020 Jan 30;20(1):3. doi: 10.1007/s11892-020-1290-7..
Keywords: Diabetes, Patient-Centered Healthcare, Patient Self-Management, Patient Adherence/Compliance, Care Management, Patient-Centered Outcomes Research, Healthcare Delivery, Children/Adolescents
Anagnostou A, Hourihane JO, Greenhawt M
The role of shared decision making in pediatric food allergy management.
Shared decision making was first highlighted in a report by the Institute of Medicine in 2001. The primary aim of this initiative was to improve the quality of care provided to patients in the United States by creating a health care system that is safe, effective, efficient, and equitable. For the purposes of this review, the investigators discussed different areas of food allergy management within a single complex case, focusing on the role of shared decision making.
AHRQ-funded; HS024599.
Citation: Anagnostou A, Hourihane JO, Greenhawt M .
The role of shared decision making in pediatric food allergy management.
J Allergy Clin Immunol Pract 2020 Jan;8(1):46-51. doi: 10.1016/j.jaip.2019.09.004..
Keywords: Children/Adolescents, Decision Making, Chronic Conditions, Care Management