Abstract：
BACKGROUND:Children with special health care needs (CSHCN) are at increased risk for functional disabilities. Care coordination has been shown to decrease unmet health service use but has yet been shown to improve functional status. We hypothesize that care coordination services lower the odds of functional disability for CSHCN and that this effect is greater within the context of a family-centered medical home. A secondary objective was to test the mediating effect of unmet care needs on functional disability. METHODS:Our sample included children ages 0 to 17 years participating the 2009-2010 National Survey of Children with Special Health Care Needs. Care coordination, unmet needs, and disability were measured by parent report. We used logistic regression models with covariate adjustment for confounding and a mediation analysis approach for binary outcomes to assess the effect of unmet needs. RESULTS:There were 34,459 children in our sample. Care coordination was associated with lower odds of having a functional disability (adjusted odds ratio 0.82, 95% confidence interval 0.77, 0.88). This effect was greater for care coordination in the context of a medical home (adjusted odds ratio 0.71, 95% confidence interval 0.66, 0.76). The relationship between care coordination and functional disability was mediated by reducing unmet services. CONCLUSIONS:Care coordination is associated with lower odds of functional disability among CSHCN, especially when delivered in the setting of a family-centered medical home. Reducing unmet service needs mediates this effect. Our findings support a central role for coordination services in improving outcomes for vulnerable children.
journal_name
Acad Pediatrjournal_title
Academic pediatricsauthors
Litt JS,McCormick MCdoi
10.1016/j.acap.2014.08.006subject
Has Abstractpub_date
2015-03-01 00:00:00pages
185-90issue
2eissn
1876-2859issn
1876-2867pii
S1876-2859(14)00321-0journal_volume
15pub_type
杂志文章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:Advocates must make decisions about the types of evidence they emphasize when communicating to cultivate support for adverse childhood experience (ACE) prevention policies. This study sought to characterize public perceptions of the persuasiveness of 12 ACE evidence statements and assess differences by ideolo...
journal_title：Academic pediatrics
pub_type： 杂志文章
doi：10.1016/j.acap.2020.05.031
更新日期：2020-06-15 00:00:00
abstract：OBJECTIVE:To determine the prevalence of overweight/obese status in children with autism spectrum disorders (ASD), identify associated characteristics, and develop a model to predict weight status. METHODS:The prevalence of overweight and obesity was determined in 2769 children with ASD enrolled in the Autism Speaks A...
journal_title：Academic pediatrics
pub_type： 杂志文章,多中心研究
doi：10.1016/j.acap.2015.03.008
更新日期：2015-07-01 00:00:00
abstract：OBJECTIVE:Despite recommendations to consume iron-, calcium-, and vitamin C-rich foods for managing blood lead levels (BLLs), limited evidence exists on how specific foods affect children's BLLs. Using data from 12- to 36-month olds (n = 992) from the 2009 to 2014 National Health and Nutrition Examination Survey, we as...
journal_title：Academic pediatrics
pub_type： 杂志文章
doi：10.1016/j.acap.2020.06.009
更新日期：2020-06-17 00:00:00
abstract：:This paper provides a primer for qualitative research in medical education. Our aim is to equip readers with a basic understanding of qualitative research and prepare them to judge the goodness of fit between qualitative research and their own research questions. We provide an overview of the reasons for choosing a qu...
journal_title：Academic pediatrics
pub_type： 杂志文章
doi：10.1016/j.acap.2011.05.001
更新日期：2011-09-01 00:00:00
abstract：:The goal of designing innovative curricula and programs in medical education is to create interventions that will change the attitudes, knowledge, skills, and behaviors of learners in order to prepare them to contribute to the health of patients and communities they serve. Systematic evaluation allows curriculum/progr...
journal_title：Academic pediatrics
pub_type： 杂志文章,评审
doi：10.1016/j.acap.2020.07.005
更新日期：2020-01-01 00:00:00
abstract：OBJECTIVE:The aim of this study was to investigate training in developmental and behavioral pediatrics (DBP) for graduating residents, their competencies in diagnosing and treating child mental health (MH) problems, and whether the amount of DBP training and/or perceived competencies are associated with perceived respo...
journal_title：Academic pediatrics
pub_type： 杂志文章
doi：10.1016/j.acap.2010.03.003
更新日期：2010-07-01 00:00:00
abstract：OBJECTIVE:Although it is known that children with mental health problems utilize primary care services more than most other children, it is unknown how addressing mental health problems in primary care affects children's subsequent services utilization. This study measures primary care utilization in the context of a r...
journal_title：Academic pediatrics
pub_type： 杂志文章,多中心研究,随机对照试验
doi：10.1016/j.acap.2010.06.012
更新日期：2010-09-01 00:00:00
abstract：BACKGROUND:Picky eating is common in children. Few studies have examined predictors of picky eating, and the association of picky eating with weight status and dietary quality is inconsistent in the literature. We aimed to identify predictors of picky eating and to test the association of picky eating with child body m...
journal_title：Academic pediatrics
pub_type： 杂志文章
doi：10.1016/j.acap.2017.08.014
更新日期：2018-04-01 00:00:00
abstract：OBJECTIVE:To explore the potential benefits and challenges of involving adolescents in the education of medical students and residents from the perspectives of adolescents who are hospitalized with chronic health conditions. METHODS:We conducted qualitative interviews with adolescents at a Canadian pediatric hospital....
journal_title：Academic pediatrics
pub_type： 杂志文章
doi：10.1016/j.acap.2018.05.007
更新日期：2019-01-01 00:00:00
abstract：OBJECTIVE:To identify factors associated with fighting among African American, Asian/Pacific Islander, Latino, and white youth, with a focus on family and school connectedness. METHODS:Subjects were 4010 adolescents (12-17 years old) from the 2003 California Health Interview Survey. Stratified logistic regression exam...
journal_title：Academic pediatrics
pub_type： 杂志文章
doi：10.1016/j.acap.2010.06.004
更新日期：2010-09-01 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:Burnout is a work-related syndrome characterized by emotional exhaustion (EE), depersonalization (DP), and lack of personal accomplishment (PA). We hypothesized that the transition into an environment of high physical, intellectual, and emotional demands of the medical profession would lead to an increase in ...
journal_title：Academic pediatrics
pub_type： 杂志文章
doi：10.1016/j.acap.2013.12.001
更新日期：2014-03-01 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 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：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：BACKGROUND:Provider elicitation of parent developmental and behavioral (DB) concerns is the foundation of DB surveillance. Language differences may affect whether providers assess parental DB concerns. OBJECTIVE:The aim of this study was to compare children in English versus Spanish primary language households by risk...
journal_title：Academic pediatrics
pub_type： 杂志文章
doi：10.1016/j.acap.2008.12.006
更新日期：2009-03-01 00:00:00
abstract：OBJECTIVE:To evaluate whether primary care provider (PCP) access to an online decision support tool is associated with a change in evidence-based primary care medical management of pediatric migraine. METHODS:In this prospective observational study, PCPs serving a target community were educated on the availability and...
journal_title：Academic pediatrics
pub_type： 杂志文章
doi：10.1016/j.acap.2019.11.017
更新日期：2020-08-01 00:00:00
abstract：OBJECTIVE:We examined changes in insurance coverage and health care utilization associated with the Affordable Care Act (ACA) among subgroups of Asian youth relative to non-Latino white youth. METHODS:Data were from the 2010 to 2017 American Community Survey and National Health Interview Survey. Difference-in-differen...
journal_title：Academic pediatrics
pub_type： 杂志文章
doi：10.1016/j.acap.2019.11.004
更新日期：2020-07-01 00:00:00
abstract：OBJECTIVE:To evaluate the effectiveness of a traditional didactic session (TDS) as compared to a self-paced, interactive, multimedia module (SPM) on the application of evidence-based medicine (EBM) skills among medical students during their inpatient pediatric rotation. METHODS:We conducted a randomized controlled tri...
journal_title：Academic pediatrics
pub_type： 杂志文章
doi：10.1016/j.acap.2020.09.012
更新日期：2020-09-30 00:00:00
abstract：OBJECTIVE:To identify the proportion of patients previously diagnosed with apparent life-threatening events (ALTE) who would meet criteria for brief resolved unexplained events (BRUE) and to identify rates of adverse outcomes in subgroups: ALTE not meeting criteria for BRUE, lower-risk BRUE, and higher-risk ALTE. METH...
journal_title：Academic pediatrics
pub_type： 杂志文章
doi：10.1016/j.acap.2019.08.001
更新日期：2019-01-01 00:00:00
abstract：BACKGROUND:Neonatal tracheal intubation (NTI) is an important clinical skill. Suboptimal performance is associated with patient harm. Simulation training can improve NTI performance. Improving performance requires an objective assessment of competency. Competency assessment tools need strong evidence of validity. We hy...
journal_title：Academic pediatrics
pub_type： 杂志文章
doi：10.1016/j.acap.2018.07.008
更新日期：2019-03-01 00:00:00
abstract：OBJECTIVE:Untreated vision problems are associated with poor school performance. Whether providing glasses alone improves performance, however, remains unknown. We sought to test whether receiving glasses was associated with improved school performance for low-income minority students in Los Angeles. METHODS:From 2017...
journal_title：Academic pediatrics
pub_type： 杂志文章
doi：10.1016/j.acap.2020.01.001
更新日期：2020-01-01 00:00:00
abstract：OBJECTIVE:Youth involvement in extracurricular activities may help prevent smoking and drinking initiation. However, the relative roles of types of extracurricular activity on these risks are unclear. Therefore, we examined the association between substance use and participation in team sports with a coach, other sport...
journal_title：Academic pediatrics
pub_type： 杂志文章
doi：10.1016/j.acap.2014.02.002
更新日期：2014-05-01 00:00:00
abstract：OBJECTIVE:To describe the extent to which parent- and teacher-reported child mental health problems vary by different indicators of socioeconomic status. METHODS:Participants were 4-5-year-old children in the Longitudinal Study of Australian Children (LSAC). Parents (N = 4968) and teacher (N = 3245) completed the 3-4-...
journal_title：Academic pediatrics
pub_type： 杂志文章
doi：10.1016/j.acap.2009.08.007
更新日期：2010-01-01 00:00:00
abstract：BACKGROUND AND PURPOSE:The coming years could be a watershed period for children and health care as the nation implements the most significant federal health care legislation in 50 years: the Accountable Care Act (ACA). A year earlier, the American Recovery and Reinvestment Act (ARRA) set up a framework and road map fo...
journal_title：Academic pediatrics
pub_type： 杂志文章
doi：10.1016/j.acap.2010.10.003
更新日期：2011-05-01 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：OBJECTIVE:Children with special health care needs (CSHCN) are at risk for decreased participation in educational and social activities, which can negatively impact their lives. The objectives of this study were to document the presence of participation restrictions for CSHCN compared with other children and to determin...
journal_title：Academic pediatrics
pub_type： 杂志文章
doi：10.1016/j.acap.2012.03.004
更新日期：2012-07-01 00:00:00
abstract：OBJECTIVE:To develop and validate a computable phenotype algorithm for identifying patient populations with sickle cell disease. METHODS:In this retrospective study we used electronic health record data from the Children's Hospital of Wisconsin to develop a computable phenotype algorithm for sickle cell disease. The a...
journal_title：Academic pediatrics
pub_type： 杂志文章
doi：10.1016/j.acap.2016.12.005
更新日期：2017-04-01 00:00:00
abstract：BACKGROUND:Little information is available to gauge residents' perceived receipt of comprehensive training and preparedness to manage children with obesity in practice. METHODS:A national, random sample of 1000 graduating pediatric residents were surveyed in 2013 on childhood overweight/obesity and preparedness to pre...
journal_title：Academic pediatrics
pub_type： 杂志文章
doi：10.1016/j.acap.2016.01.016
更新日期：2016-05-01 00:00:00
