Abstract:
OBJECTIVE:To examine insurance-based disparities in provider-related barriers to care among children in California in the wake of changes to the insurance market resulting from the Affordable Care Act. METHODS:Our sample included 6514 children (ages 0 to 11 years) from the 2014-2016 California Health Interview Survey. We examined parent reports in the past year of 1) having trouble finding a general provider for the child, 2) the child not being accepted by a provider as a new patient, 3) the child's health insurance not being accepted by a provider, or 4) any of the above. Multivariable models estimated the associations of insurance type-Medi-Cal (Medicaid), employer-sponsored insurance, or privately purchased coverage-and parent reports of these problems. RESULTS:Approximately 8% of parents had encountered at least one of these problems. Compared with parents of children with employer-sponsored insurance, parents of children with Medi-Cal or privately purchased coverage had over twice the odds of experiencing at least one of the barriers. Parents of children with Medi-Cal had over twice the odds of being told a provider would not accept their children's coverage or having trouble finding a general provider and 3times the odds of being told a provider would not accept their children as new patients. Parents of children with privately purchased coverage had over 3times the odds of being told a provider would not accept their children's coverage. CONCLUSIONS:Our study found significant disparities in provider-related barriers by insurance type among children in California.
journal_name
Acad Pediatrjournal_title
Academic pediatricsauthors
Kemmick Pintor J,Alcalá HE,Roby DH,Grande DT,Alberto CK,McKenna RM,Ortega ANdoi
10.1016/j.acap.2018.09.003subject
Has Abstractpub_date
2019-04-01 00:00:00pages
325-332issue
3eissn
1876-2859issn
1876-2867pii
S1876-2859(18)30605-3journal_volume
19pub_type
杂志文章abstract:OBJECTIVE:To determine if parents' self-efficacy in communicating with their child's pediatrician is associated with African American mothers' disclosure of psychosocial concerns during pediatric primary care visits. METHODS:Self-identified African American mothers (n = 231) of children 2 to 5 years were recruited fro...
journal_title:Academic pediatrics
pub_type: 杂志文章,多中心研究
doi:10.1016/j.acap.2014.03.002
更新日期:2014-07-01 00:00:00
abstract:PURPOSE:Telephone interpretation and recent technology advances assist patients with more timely access to rare languages, but no one has examined the role of this technology in the medical setting and how medical students can be prepared for their use. We sought to determine if structured curriculum on interpretation ...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2017.11.010
更新日期:2018-03-01 00:00:00
abstract::Education, like clinical medicine, should be based on the most current evidence in the field. Unfortunately, medical educators can be overwhelmed by the sheer volume and range of resources for this literature. This article provides an overview of 15 articles from 2016 that the authors consider the top articles in the ...
journal_title:Academic pediatrics
pub_type: 杂志文章,评审
doi:10.1016/j.acap.2018.01.015
更新日期:2018-07-01 00:00:00
abstract:OBJECTIVE:To evaluate a pediatric otoscopy curriculum with the use of outcome measures that included assessment of skills with real patients. METHODS:Thirty-three residents in an intervention group from 2 institutions received the curriculum. In the previous year, 21 residents in a nonintervention group did not receiv...
journal_title:Academic pediatrics
pub_type: 杂志文章,多中心研究
doi:10.1016/j.acap.2018.02.009
更新日期:2018-08-01 00:00:00
abstract:OBJECTIVE:To examine the association between chronic school absenteeism and adverse childhood experiences (ACEs) among school-age children. METHODS:We conducted a secondary analysis of data from the 2011-2012 National Survey of Children's Health including children 6 to 17 years old. The primary outcome variable was ch...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2017.09.013
更新日期:2017-01-01 00:00:00
abstract::Though the use of mobile devices (e.g., tablets, smartphones) by young children is pervasive and increasing, research relating children's use of mobile devices to their development is only beginning to emerge. Learning, language development, and self-regulation skills among children aged zero to five are of particular...
journal_title:Academic pediatrics
pub_type: 杂志文章,评审
doi:10.1016/j.acap.2021.01.007
更新日期:2021-01-21 00:00:00
abstract::Management of referral and consultation is an entrustable professional activity for pediatric residents; however, few tools exist to teach these skills. We designed and implemented tools to prompt discussion, feedback, and reflection about the process of referral, notably including the family's perspective. ...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2018.01.010
更新日期:2018-04-01 00:00:00
abstract:OBJECTIVE:To evaluate the effects of simple and elaborated health care provider (HCP) reminder prompts on human papillomavirus (HPV) vaccine initiation rates. METHODS:Twenty-nine pediatric HCPs serving 5 pediatric clinics were randomized to 1 of 3 arms: 1) usual practice control, 2) simple reminder prompt, and 3) elab...
journal_title:Academic pediatrics
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.acap.2017.11.002
更新日期:2018-03-01 00:00:00
abstract:OBJECTIVE:To determine if use of a health literacy low-inference, self-assessment measure (LISAM), promoted behavior change as measured by increased use of health literacy communication skills (HLCS). METHODS:The LISAM is a tool used by educators to self-assess their performances after giving a lecture. The tool is lo...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2020.02.019
更新日期:2020-07-01 00:00:00
abstract:BACKGROUND:The American Board of Pediatrics requires that pediatricians be able to initiate stabilization of a newborn. After residency, 45% of general pediatricians routinely attend deliveries. However, there is no standard approach or tool to measure resident proficiency in newborn resuscitation across training progr...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2018.09.004
更新日期:2019-01-01 00:00:00
abstract:OBJECTIVE:To determine which of the 21 general pediatrics milestone subcompetencies are most difficult to assess using traditional methodologies and which are best suited to simulation-based assessment. METHODS:We surveyed 2 samples: pediatric simulation experts and pediatric program directors. Respondents were asked ...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2015.09.007
更新日期:2016-04-01 00:00:00
abstract::When Congress reenacted the Child Health Insurance Program (CHIP) in 2009, it incorporated a range of dental provisions that had not been considered when the program was initiated in 1997. This paper posits that this change evidences the establishment of pediatric oral health as a distinct policy issue within Congress...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2009.09.002
更新日期:2009-11-01 00:00:00
abstract:OBJECTIVE:To examine the prevalence trends and coexisting conditions in attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), and intellectual disability (ID) in the pediatric Supplemental Security Income (SSI) population and general population. METHODS:The Social Security Administration (SS...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2015.05.002
更新日期:2015-07-01 00:00:00
abstract:BACKGROUND:Prior health services research (HSR) agendas for children have been published, but major ones are now over 15 years old and do not reflect augmented understanding of the drivers and determinants of children's health; recent changes in the organization, financing, and delivery of health care; a growing emphas...
journal_title:Academic pediatrics
pub_type: 杂志文章,评审
doi:10.1016/j.acap.2017.04.015
更新日期:2017-01-01 00:00:00
abstract:OBJECTIVE:To determine the initial effectiveness of a novel, pediatric office-based intervention in motivating mothers to seek further assessment of positive depression screens. METHODS:In this pilot randomized controlled trial, English-speaking mothers (n = 104) with positive 2-question depression screens and present...
journal_title:Academic pediatrics
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.acap.2014.11.008
更新日期:2015-05-01 00:00:00
abstract:OBJECTIVE:Hispanic parents in the United States are disproportionately affected by low health literacy and limited English proficiency (LEP). We examined associations between health literacy, LEP, and liquid medication dosing errors in Hispanic parents. METHODS:Cross-sectional analysis of data from a multisite randomi...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2016.10.001
更新日期:2017-01-01 00:00:00
abstract:OBJECTIVE:To compare job search experience and postresidency position of pediatric residents on the basis of childhood location (United States or international) and medical school location (American medical graduates [AMG] or international medical graduate [IMG]). METHODS:Annual national random samples of 1000 graduat...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2015.06.005
更新日期:2015-09-01 00:00:00
abstract:OBJECTIVE:Previous research suggests that cognitive functioning is associated with the risk of several adult psychiatric disorders. In this study we investigated whether adolescents who perform worse than expected at secondary school are at a higher risk for general mental health problems. METHODS:In a cross-sectional...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2017.04.016
更新日期:2017-08-01 00:00:00
abstract:OBJECTIVE:The Advisory Committee on Immunization Practices (ACIP) has recommended routine human papillomavirus (HPV) vaccination at age 11 or 12 years for girls since 2006 and for boys since 2011. We sought to describe adolescent HPV vaccination coverage, doses administered from 2009 to 2012, and age at first vaccinati...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2014.03.005
更新日期:2014-09-01 00:00:00
abstract:OBJECTIVE:Unhealthy behaviors are a major cause of chronic disease. Preappointment screening has been suggested as one way to improve preventive care delivery related to these behaviors by specifying risks to be addressed. We aimed to determine whether screening for health-related behaviors before the clinical encounte...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2018.01.008
更新日期:2018-01-01 00:00:00
abstract::Electronic medical records (EMRs) are increasingly common in pediatric patient care. EMR data represent a relatively novel and rich resource for clinical research. The fact, however, that pediatric EMR data are collected for the purposes of clinical documentation and billing rather than research creates obstacles to t...
journal_title:Academic pediatrics
pub_type: 杂志文章,评审
doi:10.1016/j.acap.2011.02.007
更新日期:2011-07-01 00:00:00
abstract:OBJECTIVES:The cognitive expertise of Pediatric Hospitalists (PH) lies not in standard knowledge but in making decisions under conditions of uncertainty. To maintain expertise, PH should engage in deliberate practice via self-assessments that promote higher-level cognitive processes necessary to address problems with m...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2020.10.003
更新日期:2020-10-14 00:00:00
abstract::Tobacco use is the leading cause of preventable death in the United States, and exposure to tobacco smoke harms children from conception forward. There is no safe level of tobacco exposure. Although overall smoking rates have declined, the advent of new products, such as electronic cigarettes, threatens to perpetuate ...
journal_title:Academic pediatrics
pub_type: 杂志文章,评审
doi:10.1016/j.acap.2016.12.010
更新日期:2017-04-01 00:00:00
abstract:OBJECTIVE:The goal of this study was to categorize reasons behind missed opportunities for human papillomavirus (HPV) vaccine initiation in an under-resourced population and to identify associated patient and clinic characteristics. METHODS:Manual chart review was performed for patients aged 11 to 18 years who visited...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2020.12.003
更新日期:2020-12-21 00:00:00
abstract:OBJECTIVE:Depression among adolescents is a leading public health problem. Although screening for adolescent depression in primary care is strongly recommended, screening rates remain low. Effective quality improvement (QI) initiatives can facilitate change. This study aims to assess the impact of a QI learning collabo...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2019.02.014
更新日期:2019-01-01 00:00:00
abstract::All medical educators have experienced "teachable moments" during their career, and most can likely share examples of these moments from both training and their role as educators. In addition, most if not all have faced a situation in which an educational opportunity fell short or was missed entirely. This View from t...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2020.08.011
更新日期:2020-08-20 00:00:00
abstract:OBJECTIVES:To develop, validate, and test the feasibility of implementation of 4 new quality measures assessing emergency department (ED) and inpatient care for suicidal youth. METHODS:Four quality measures were developed to assess hospital-based care for suicidal youth. These measures, focused on counseling caregiver...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2017.09.017
更新日期:2018-04-01 00:00:00
abstract:OBJECTIVE:There are many studies of the Pediatric Symptom Checklist (PSC), but none has followed a naturalistic sample longitudinally. We aimed to examine persistence and change in PSC scores over time in children seen in an ambulatory pediatric setting. METHODS:The sample of 1033 patients was PSC screened at 2 consec...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2009.03.004
更新日期:2009-07-01 00:00:00
abstract:OBJECTIVE:Pregnancy is common during residency, yet the duration of allowed paid leave is inadequate and utilizing unpaid family medical leave act (FMLA) time has financial and professional consequences. We evaluated the effectiveness of a novel parenting elective, consistent with educational goals for pediatric reside...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2020.02.008
更新日期:2020-07-01 00:00:00
abstract:OBJECTIVE:(1) To describe coparenting among adolescent mothers and the biological fathers of their children. (2) To examine the effects of coparenting on young children's social-emotional development and whether these effects vary by father's residence status, parental education, and child characteristics. METHODS:Sec...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2012.07.007
更新日期:2012-11-01 00:00:00