Abstract:
BACKGROUND AND OBJECTIVE:In an effort to transform the health care system, payers and physicians are experimenting with new payment models, mostly in an effort to move from a volume-based system to one based on value. We conducted a national survey to evaluate pediatricians' experience with and views about new value-based models of payment. METHODS:An American Academy of Pediatrics 2016 member survey was used to assess provider and practice characteristics, provider experience with value-based payments (VBPs) (through accountable care organizations [ACOs] or pay for quality performance), and provider views about new payment models. We used descriptive statistics and multivariable logistic regression models to examine relationships between experience and views. RESULTS:The survey response rate was 48.7% (n = 786 of 1614). Of practicing general pediatricians, 52% reported experience with VBP, 32% believed payment for quality metrics have a "positive impact" on pediatricians' ability to provide quality care for patients, and 12% believed ACOs have a positive impact. Adjusting for covariates, respondents experienced with payments for quality metrics (adjusted odds ratio: 2.01; 95% confidence interval 1.26-3.19) and ACOs (odds ratio: 6.68; 95% confidence interval 3.55-13.20) were more likely to report a positive impact. CONCLUSIONS:Although experience and views vary, just more than half of surveyed pediatricians report receiving some form of VBP. Pediatricians reporting this experience are more likely to feel that these payment models have a positive impact on patient care when compared with pediatricians without this experience.
journal_name
Pediatricsjournal_title
Pediatricsauthors
Tieder JS,Sisk B,Hudak M,Richerson JE,Perrin JMdoi
10.1542/peds.2018-0502subject
Has Abstractpub_date
2018-10-01 00:00:00issue
4eissn
0031-4005issn
1098-4275pii
peds.2018-0502journal_volume
142pub_type
杂志文章相关文献
PEDIATRICS文献大全abstract:BACKGROUND AND OBJECTIVES:Neonatal hypoglycemia has been associated with abnormalities on brain imaging and a spectrum of developmental delays, although historical and recent studies show conflicting results. We compared the cognitive, academic, and behavioral outcomes of preterm infants with neonatal hypoglycemia with...
journal_title:Pediatrics
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1542/peds.2016-1424
更新日期:2016-12-01 00:00:00
abstract:OBJECTIVES:Our aim for this study was to determine the prevalence of dyssomnias and various parasomnias in early childhood and to describe their temporal evolution, gender differences, and correlates. METHODS:This research is part of a longitudinal study of child development. A randomized, 3-level, stratified survey d...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2006-2132
更新日期:2007-05-01 00:00:00
abstract:OBJECTIVE:Substance abuse remains one of the major threats to adolescent health in Western cultures. The study aim was to ascertain the extent of association between pubertal development and early adolescent substance use. METHODS:The design was a cross-sectional survey of 10- to 15-year-old subjects in the states of ...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2003-0626-F
更新日期:2004-09-01 00:00:00
abstract:BACKGROUND:Varicella vaccine was licensed in the United States in 1995 for individuals ≥12 months of age. A second dose was recommended in the United States in June 2006. Varicella incidence and vaccine effectiveness were assessed in a 14-year prospective study conducted at Kaiser Permanente Northern California. METHO...
journal_title:Pediatrics
pub_type: 杂志文章,多中心研究
doi:10.1542/peds.2012-3303
更新日期:2013-05-01 00:00:00
abstract::With a randomized clinical trial, the possibility was assessed that a tracheal instillation of pulmonary surfactant prior to the first breath might prevent the development of some of the signs of neonatal respiratory distress syndrome. Of the 72 infants in the trial, all born at a gestational age of less than 30 weeks...
journal_title:Pediatrics
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1985-08-01 00:00:00
abstract:CONTEXT:The effectiveness of many interventions aimed at reducing the risk of retinopathy has not been well established. OBJECTIVE:To estimate the effectiveness of nutritional interventions, oxygen saturation targeting, blood transfusion management, and infection prevention on the incidence of retinopathy of prematuri...
journal_title:Pediatrics
pub_type: 杂志文章,meta分析,评审
doi:10.1542/peds.2015-3387
更新日期:2016-04-01 00:00:00
abstract:BACKGROUND:Despite the success of childhood immunizations in prevention of infectious diseases, questions remain about the safety of vaccines in medically fragile children with inborn errors of metabolism such as urea cycle disorders (UCDs). Patients with UCDs are subject to hyperammonemic episodes (HAEs) after infecti...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2010-1628
更新日期:2011-05-01 00:00:00
abstract:OBJECTIVE:To examine the perspectives of low-income parents on redesigning well-child care (WCC) for children aged 0 to 3 years, focusing on possible changes in 3 major domains: providers, locations, and formats. METHODS:Eight focus groups (4 English and 4 Spanish) were conducted with 56 parents of children aged 6 mon...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2008-2608
更新日期:2009-07-01 00:00:00
abstract:OBJECTIVES:To evaluate the association of negative stressful life events experienced over 12 months and the risk of moderate to severe immune suppression among children and youth infected with human immunodeficiency virus type 1 (HIV-1). METHODS:Longitudinal study of 618 HIV-1-infected children, baseline ages 1 to 20 ...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.106.3.540
更新日期:2000-09-01 00:00:00
abstract::The clinical course of 42 children with intracranial pressure monitoring was reviewed. Intracranial hypertension was documented in a variety of diagnostic categories. Therapy was titrated to maintain a baseline intracranial pressure of less than 15 torr (mm Hg), and to decrease the frequency of spontaneous and reactiv...
journal_title:Pediatrics
pub_type: 杂志文章
doi:
更新日期:1977-04-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to evaluate previous teacher reports that children exposed to cocaine prenatally have more problem behaviors. METHODS:A historical, prospective design was used. Maternal subjects (n = 116) of 6-year-old singleton, term (>/=36 weeks) children, and the children's first-grade teachers ...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.102.4.945
更新日期:1998-10-01 00:00:00
abstract:OBJECTIVE:To determine whether medically unexplained recurrent abdominal pain (RAP) in childhood predicts abdominal pain, irritable bowel syndrome (IBS), other somatic complaints, and psychiatric symptoms and disorders in young adulthood. METHODS:A sample of 28 young adults evaluated for RAP between the ages of 6 and ...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.108.1.e1
更新日期:2001-07-01 00:00:00
abstract:OBJECTIVE:The goal of this study was to determine if congenital human herpesvirus-6 (HHV-6) infection influences early neurodevelopment. METHODS:We enrolled 57 newborns with HHV-6 congenital infection and 242 control newborns without congenital infection into a prospective, double-blind study with 4 visits between 4 a...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2014-0886
更新日期:2014-12-01 00:00:00
abstract::The evolution of tone and reflexes from 25 weeks postmenstrual age (gestational age plus chronologic age) to term in a population of 42 surviving infants is described. The infants were born in 1983 at the Johns Hopkins Hospital, had birth weights less than 1300 g, were examined weekly until neonatal intensive care uni...
journal_title:Pediatrics
pub_type: 杂志文章
doi:
更新日期:1990-03-01 00:00:00
abstract:OBJECTIVE:The goal was to estimate the level of delivered continuous positive airway pressure by measuring oral cavity pressure with the mouth closed in infants of various weights and ages treated with heated, humidified high-flow nasal cannula at flow rates of 1-5 L/minute. We hypothesized that clinically relevant lev...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2007-0957
更新日期:2008-01-01 00:00:00
abstract:BACKGROUND:Previous studies have shown that breastfeeding is associated with reductions in the risk of common infections among infants; however, whether breastfeeding confers longer term protection is inconclusive. METHODS:We linked data from the 2005-2007 IFPS II (Infant Feeding Practices Study II) and follow-up data...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2014-0646D
更新日期:2014-09-01 00:00:00
abstract::The transcripts of tape-recorded interviews of pediatric endocrinologists and patients with Turner's syndrome and their parents were reviewed in consultation with child psychoanalysts in order to evaluate certain aspects of communication between patients and doctors. The transcripts showed that the doctors often talke...
journal_title:Pediatrics
pub_type: 杂志文章
doi:
更新日期:1975-03-01 00:00:00
abstract:OBJECTIVE:To determine the usefulness of measurements of the vaginal opening and amount of hymenal tissue present inferiorly and laterally in the diagnosis of vaginal penetration. METHODS:The transhymenal diameters and the amount of tissue present between the hymenal edge and vestibule inferiorly at 6 o'clock and late...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.109.2.228
更新日期:2002-02-01 00:00:00
abstract:OBJECTIVE:The anion exchanger gene (AE1) or band 3 encodes a chloride-bicarbonate (Cl(-)/HCO(3)(-)) exchanger expressed in the erythrocyte and in the renal alpha-intercalated cells involved in urine acidification. The purpose of the present study was to screen for mutations in the AE1 gene in 2 brothers (10 and 15 year...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.112.6.1361
更新日期:2003-12-01 00:00:00
abstract:OBJECTIVE:Depression is common among adolescents, but rates increase significantly in the presence of chronic health conditions. Outpatient screening for depression is recommended but rarely formally conducted due to barriers of implementation. METHODS:To provide a model for depression screening of youth with chronic ...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2013-0681
更新日期:2013-11-01 00:00:00
abstract::Developmental screening tests are in widespread use, but few reliable and valid tests are available. The most frequently used screening instrument for detecting young children who are at risk for developmental delays is the Denver Developmental Screening Test (DDST). Although the DDST has excellent test specificity, o...
journal_title:Pediatrics
pub_type: 杂志文章,评审
doi:
更新日期:1989-04-01 00:00:00
abstract:BACKGROUND:We present a long-term safety, immunogenicity, and effectiveness study of a quadrivalent human papillomavirus (HPV4) vaccine. METHODS:Sexually naive boys and girls aged 9 to 15 years (N = 1781) were assigned (2:1) to receive HPV4 vaccine or saline placebo at day 1 and months 2 and 6. At month 30, the placeb...
journal_title:Pediatrics
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1542/peds.2013-4144
更新日期:2014-09-01 00:00:00
abstract:OBJECTIVE:Our goal was to describe the neurologic and clinical features of affected males from families with X-linked patterns of severe mental retardation, hypotonia, recurrent respiratory infection, and microduplication of Xq28 that consistently includes the MECP2 (methyl-CpG binding protein 2) gene. STUDY DESIGN:To...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2006-0395
更新日期:2006-12-01 00:00:00
abstract:OBJECTIVE:We sought to evaluate the association between early protein and energy intake and neurodevelopment and growth of extremely low birth weight (<1000 g) infants. STUDY DESIGN:Daily protein and energy intakes were collected by chart review for the first 4 weeks of life on 148 extremely low birth weight survivors...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2008-0211
更新日期:2009-05-01 00:00:00
abstract:OBJECTIVE:To determine the primary caretakers of children born to women with human immunodeficiency virus (HIV) infection. METHODS:We interviewed women at least 18 years of age who have been reported with HIV infection or acquired immunodeficiency syndrome to local health departments in 10 cities and states regarding ...
journal_title:Pediatrics
pub_type: 杂志文章,多中心研究
doi:
更新日期:1995-04-01 00:00:00
abstract:BACKGROUND:Use of complementary and alternative medical therapies is common and increasing, particularly for children with chronic disease. OBJECTIVES:The purpose of this work was to describe the use of complementary and alternative medicine by children and to identify factors that may influence the use of complementa...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2006-3105
更新日期:2007-07-01 00:00:00
abstract::Fragile X syndrome (an FMR1-related disorder) is the most commonly inherited form of mental retardation. Early physical recognition is difficult, so boys with developmental delay should be strongly considered for molecular testing. The characteristic adult phenotype usually does not develop until the second decade of ...
journal_title:Pediatrics
pub_type: 杂志文章,评审
doi:10.1542/peds.2010-3500
更新日期:2011-05-01 00:00:00
abstract:OBJECTIVE:Previous growth studies on children born small for gestational age (SGA) indicate that birth length, weight, and target height are important predictors for postnatal catch-up growth in SGA. Their influences on different phases of catch-up growth are still not described. The aim of this study was to clarify th...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.102.6.e72
更新日期:1998-12-01 00:00:00
abstract:BACKGROUND:Children with trisomy 13 and trisomy 18 (T13-18) have low survival rates and survivors have significant disabilities. For these reasons, interventions are generally not recommended by providers. After a diagnosis, parents may turn to support groups for additional information. METHODS:We surveyed parents of ...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2012-0151
更新日期:2012-08-01 00:00:00
abstract:OBJECTIVES:To examine the association of intrapartum temperature elevation with adverse neonatal outcome among low-risk women receiving epidural analgesia and evaluate the association of epidural with adverse neonatal outcome without temperature elevation. METHODS:We studied all low-risk nulliparous women with singlet...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2010-2301
更新日期:2012-02-01 00:00:00