Abstract：
OBJECTIVE:To examine the relationship between continuity of care for children with medical complexity (CMC) and emergency department (ED) utilization, care coordination quality, and family effects related to care coordination. METHODS:We measured ED utilization and primary care continuity with the Bice-Boxerman continuity of care index for 1477 CMC using administrative data from Minnesota and Washington state Medicaid agencies. For a subset of 186 of these CMC a caregiver survey was used to measure care coordination quality (using items adapted from the Consumer Assessment of Healthcare Providers and System Adult Health Plan Survey) and family impact (using items adapted from the National Survey of Children with Special Health Care Needs). Multivariable regression was used to examine the relationship between continuity, entered as a continuous variable ranging from 0 to 1, and the outcomes. RESULTS:The median continuity was 0.27 (interquartile range [IQR], 0.12-0.48) in the administrative data cohort and 0.27 (IQR, 0.14-0.43) in the survey cohort. Compared with children with a continuity score of 0, children with a score of 1 had lower odds of having ≥1 ED visit (odds ratio, 0.65; 95% confidence interval [CI], 0.46-0.93; P = .017) and their caregivers reported higher scores for the measure of receipt of care coordination (β = 35.2 on a 0-100 scale; 95% CI, 11.5-58.9; P = .004). There was no association between continuity and family impact. CONCLUSIONS:Continuity of care holds promise as a quality measure for CMC because of its association with lower ED utilization and more frequent receipt of care coordination.
journal_name
Acad Pediatrjournal_title
Academic pediatricsauthors
Arthur KC,Mangione-Smith R,Burkhart Q,Parast L,Liu H,Elliott MN,McGlynn EA,Schneider ECdoi
10.1016/j.acap.2018.04.009subject
Has Abstractpub_date
2018-08-01 00:00:00pages
669-676issue
6eissn
1876-2859issn
1876-2867pii
S1876-2859(18)30175-Xjournal_volume
18pub_type
杂志文章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：: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 examine general dental and orthodontic utilization and expenditures by health insurance status, public health insurance eligibility, and sociodemographic characteristics among children aged 0 to 17 years using data from 2010-2012. METHODS:Nationally representative data from the Medical Expenditure Panel S...
journal_title：Academic pediatrics
pub_type： 杂志文章
doi：10.1016/j.acap.2016.02.013
更新日期：2016-05-01 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：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：OBJECTIVE:Accurate parental weight perception of one's child is an important step in addressing healthy behaviors, but its associations with socioeconomic status (SES) and household food insecurity (HFI) are unclear. We aimed to assess the association of parental weight perception with HFI. METHODS:This was a secondar...
journal_title：Academic pediatrics
pub_type： 杂志文章
doi：10.1016/j.acap.2019.04.009
更新日期：2020-03-01 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：OBJECTIVE:To measure the difference in prescribing error rates between 2 clinics, 1 with a system in place to reduce errors and 1 with no such system; to determine variables that affect the likelihood of prescription errors. METHODS:This was a retrospective study at 2 university-based general pediatric clinics utilizi...
journal_title：Academic pediatrics
pub_type： 杂志文章
doi：10.1016/j.acap.2014.03.018
更新日期：2014-09-01 00:00:00
abstract：OBJECTIVE:There has been a rapid increase in the number of pediatric hospitalist programs in the United States. As most pediatric hospitalist services are believed to be subsidized by hospitals, gaining a better understanding of the rationale for these subsidies is critical to the future success and existence of these ...
journal_title：Academic pediatrics
pub_type： 杂志文章
doi：10.1016/j.acap.2009.01.003
更新日期：2009-05-01 00:00:00
abstract：OBJECTIVE:Being asleep at the time of a residential fire increases fire-related fatality risk. This study tested whether children awaken from slow wave sleep and perform an escape procedure better to a voice smoke alarm that uses their mother's voice compared with a female stranger's voice or a low-frequency tone alarm...
journal_title：Academic pediatrics
pub_type： 杂志文章
doi：10.1016/j.acap.2019.06.016
更新日期：2020-04-01 00:00:00
abstract：OBJECTIVE:A parent-child relational framework was used as a method to train pediatric residents in basic knowledge and observation skills for the assessment of child development. Components of the training framework and its preliminary validation as an alternative to milestone-based approaches are described. METHODS:P...
journal_title：Academic pediatrics
pub_type： 杂志文章
doi：10.1016/j.acap.2016.09.005
更新日期：2017-01-01 00:00:00
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：OBJECTIVE:To investigate timing and strength of associations between mental health and overweight in childhood; to investigate how the cumulative burden of each of these problems affects the other. METHODS:Participants were 3197 children in the population-based Longitudinal Study of Australian Children. At 4 biennial ...
journal_title：Academic pediatrics
pub_type： 杂志文章
doi：10.1016/j.acap.2012.12.001
更新日期：2013-03-01 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：OBJECTIVE:To determine pediatric resident training and preparation for 14 Accreditation Council for Graduate Medical Education (ACGME)-required procedures. METHODS:We included a national, random sample of 1000 graduating pediatric residents in 2015. For each of the ACGME-required procedures, residents were asked if th...
journal_title：Academic pediatrics
pub_type： 杂志文章
doi：10.1016/j.acap.2017.08.001
更新日期：2018-01-01 00:00:00
abstract：OBJECTIVE:Since the introduction of resident work-hour standards, pediatric residency programs have struggled to preserve robust continuity clinic experiences. Many programs have resorted to more flexible approaches to resident scheduling. We know little regarding the impact of such changes. We compared 2 continuity cl...
journal_title：Academic pediatrics
pub_type： 杂志文章
doi：10.1016/j.acap.2009.11.002
更新日期：2010-03-01 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：BACKGROUND:Adults tend to underestimate their personal risk of disease, but little is known about parents' perceptions of children's risk. METHODS:In total, 648 parents of children 0 to 18 years old attending 2 pediatric practices were surveyed about their children's exposure to smoking; 344 parents with children ≥2 y...
journal_title：Academic pediatrics
pub_type： 杂志文章
doi：10.1016/j.acap.2018.09.008
更新日期：2019-01-01 00:00:00
abstract：OBJECTIVE:Goals of care discussions are crucial in helping parents navigate complex medical decisions and shown to improve quality of care. Little is known about whether physicians elicit or address parents' goals during a child's hospitalization. The purpose of this study was to understand the current practice of goal...
journal_title：Academic pediatrics
pub_type： 杂志文章
doi：10.1016/j.acap.2020.05.016
更新日期：2020-05-31 00:00:00
abstract：BACKGROUND:Limited English proficiency (LEP) is a known barrier to preventive care. Children from families with LEP face socioeconomic circumstances associated with increased odds of developmental delays and decreased participation in early care and education programs. Little is known about developmental surveillance a...
journal_title：Academic pediatrics
pub_type： 杂志文章
doi：10.1016/j.acap.2015.12.007
更新日期：2016-09-01 00:00:00
abstract：BACKGROUND:There are limited training opportunities for pediatricians in caring for children with medical complexity (CMC) in the home and community. Prior studies have described a lack of comfort caring for CMC among pediatric residents. OBJECTIVE:1) To evaluate the impact of participation in a virtual home visit cur...
journal_title：Academic pediatrics
pub_type： 杂志文章
doi：10.1016/j.acap.2020.05.001
更新日期：2020-01-01 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：OBJECTIVE:Diagnostic errors (DEs), which encompass failures of accuracy, timeliness, or patient communication, cause appreciable morbidity but are understudied in pediatrics. Pediatricians have expressed interest in reducing high-frequency/subacute DEs, but their epidemiology remains unknown. The objective of this stud...
journal_title：Academic pediatrics
pub_type： 杂志文章
doi：10.1016/j.acap.2017.08.005
更新日期：2018-03-01 00:00:00
abstract：OBJECTIVE:Validated questionnaires help community pediatric services to identify emotional and behavioral problems (EBPs). This study assesses the psychometric properties of the self-report version of the Strengths and Difficulties Questionnaire (SDQ) for the identification of EBPs in adolescents (13 to 14years old) an...
journal_title：Academic pediatrics
pub_type： 杂志文章
doi：10.1016/j.acap.2018.12.008
更新日期：2019-01-01 00:00:00
abstract：OBJECTIVE:To compare preventive care quality for children at risk and not at risk for developmental, behavioral, or social delays. METHODS:Using the 2007 National Survey of Children's Health (n = 22,269), we used the Parents' Evaluation of Developmental Status (PEDS) questionnaire to identify children ages 10 months t...
journal_title：Academic pediatrics
pub_type： 杂志文章
doi：10.1016/j.acap.2012.05.003
更新日期：2012-09-01 00:00:00
abstract：:Population health is associated with the socioeconomic characteristics of neighborhoods. There is considerable scientific and policy interest in community-level interventions to alleviate child poverty. Intergenerational poverty is associated with inequitable access to opportunities. Improving opportunity structures w...
journal_title：Academic pediatrics
pub_type： 杂志文章,评审
doi：10.1016/j.acap.2016.01.013
更新日期：2016-04-01 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:To describe influences on shared decision making between primary care pediatricians and parents of young children with autism spectrum disorder (ASD). METHODS:We conducted a qualitative study using key informant interviews with 20 pediatricians of varying experience from 10 primary care practices and 20 Engl...
journal_title：Academic pediatrics
pub_type： 杂志文章
doi：10.1016/j.acap.2016.04.007
更新日期：2016-08-01 00:00:00
abstract：OBJECTIVE:The Core Entrustable Professional Activities for Entering Residency (Core EPAs) were developed to address the gap between medical school and residency. There is a lack of instruments to measure performance of the Core EPAs in clerkships. We describe the operationalization and outcomes of a workplace-based ass...
journal_title：Academic pediatrics
pub_type： 杂志文章
doi：10.1016/j.acap.2020.09.016
更新日期：2020-10-07 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
