Abstract:
OBJECTIVE:To compare the prevalence of a medical home for children with public versus private insurance and identify components of the medical home that contribute to any differences. METHODS:We performed a secondary data analysis of the 2007 National Survey of Children's Health. A medical home was defined as meeting each of 5 components: 1) usual source of care; 2) personal doctor/nurse; 3) family-centered care; 4) care coordination, if needed; and 5) no problems getting a referral, if needed. We estimated the national prevalence of the medical home and its components for children with public versus private insurance. Comparisons were made using logistic regression, unadjusted and adjusted for sociodemographic factors. RESULTS:A total of 67% of privately insured children met all 5 components of the medical home, compared with only 45% of publicly insured children (P < .001). The gap in medical home prevalence between public and private groups remained significant after controlling for sociodemographic characteristics (public vs private adjusted odds ratio [AOR] 0.82; 95% confidence interval [95% CI] 0.73-0.92). Over 90% of children in both groups reported having a usual source of care and a personal doctor/nurse. Only 58% of publicly insured children reported family-centered care, compared with 76% of privately insured children (P < .001). This difference was significant after adjustment for sociodemographic characteristics (public vs private AOR 0.87; 95% CI 0.77-0.99). CONCLUSIONS:Significant medical home disparities exist between publicly and privately insured children, driven primarily by disparities in family-centered care. Efforts to promote the medical home must recognize and address determinants of family-centered care.
journal_name
Acad Pediatrjournal_title
Academic pediatricsauthors
Zickafoose JS,Gebremariam A,Clark SJ,Davis MMdoi
10.1016/j.acap.2011.03.006subject
Has Abstractpub_date
2011-07-01 00:00:00pages
305-10issue
4eissn
1876-2859issn
1876-2867pii
S1876-2859(11)00069-6journal_volume
11pub_type
杂志文章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:Reach Out and Read (ROR) is a primary care-based intervention supported by considerable evidence regarding its efficacy. Implementation of ROR, however, varies across participating sites. The objective of this study was to identify practice attributes associated with variability in ROR implementation. METHOD...
journal_title:Academic pediatrics
pub_type: 杂志文章,多中心研究
doi:10.1016/j.acap.2008.10.004
更新日期:2009-01-01 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: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: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: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:Many pediatric residents suffer from burnout. We aimed to describe the prevalence, source, and epidemiology of bullying, discrimination, harassment, and physical violence, and the relationship between these experiences and burnout. METHODS:We analyzed data from the Spring, 2019 Pediatric Resident Burnout an...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2020.02.023
更新日期:2020-01-01 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: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: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: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: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:To identify whether psychosocial stress exposure during early childhood predicts subsequent increased eating in the absence of hunger (EAH), emotional overeating, food responsiveness, and enjoyment of food. METHODS:This was an observational longitudinal study. Among 207 low-income children (54.6% non-Hispani...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2018.01.007
更新日期:2018-08-01 00:00:00
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 contin...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2018.04.009
更新日期:2018-08-01 00:00:00
abstract:OBJECTIVE:To examine the association of adolescent asthma-related anxiety, social anxiety, separation anxiety, and caregiver asthma-related anxiety with asthma care by urban adolescents. METHODS:Participants were 386 ethnic minority adolescents (mean age 12.8 years) with persistent asthma and their caregivers. Adolesc...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2016.03.009
更新日期:2016-01-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to determine the percentage of hospitals with adequate sample size to meaningfully compare performance by using the Agency for Healthcare Research and Quality (AHRQ) pediatric quality indicators (PDIs), which measure pediatric inpatient adverse events such as decubitus ulcer rate and...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2010.04.025
更新日期:2010-07-01 00:00:00
abstract:OBJECTIVE:In October 2016, the American Board of Medical Specialties approved the petition for pediatric hospital medicine (PHM) to become the newest pediatric subspecialty. Knowledge about residents entering the PHM workforce is needed to inform certification and fellowship accreditation. This study describes the char...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2017.05.001
更新日期:2018-03-01 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: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 describe the delivery of well-child care and its components; to compare that delivery with recommendations in Bright Futures; and to compare delivery of well-child care for children with special health care needs with that for children without special needs. METHODS:Over a 10-week period, 2 medical studen...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2010.12.008
更新日期:2011-01-01 00:00:00
abstract:OBJECTIVE:Guidelines recommend closer outpatient follow-up for exclusively breastfed newborns, especially those with pronounced weight loss, because of increased risk of hyperbilirubinemia and dehydration that might require readmission. Our objective was to determine how feeding method and weight loss are associated wi...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2017.11.005
更新日期:2018-08-01 00:00:00
abstract:OBJECTIVE:Promoting safe firearm storage in pediatric primary care is one way to address youth suicide by firearm. The study objective was to determine the perspectives of primary care physicians (PCPs) and leaders of primary care practices regarding the acceptability and use of screening, counseling, and firearm locks...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2018.11.007
更新日期:2019-08-01 00:00:00
abstract:OBJECTIVE:We aimed to examine abusive head trauma (AHT) incidence before, during and after the recession of 2007-2009 in 3 US regions and assess the association of economic measures with AHT incidence. METHODS:Data for children <5 years old diagnosed with AHT between January 1, 2004, and December 31, 2012, in 3 region...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2015.05.008
更新日期:2016-04-01 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: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: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:BACKGROUND:Use of complementary and alternative medical (CAM) therapies is common among adults with mental health concerns, but little is known about CAM use among adolescents with mental health concerns. METHODS:Data from the 2007 National Health Interview Survey were analyzed for youth from 7 to 17 years old. The st...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2013.05.001
更新日期:2013-11-01 00:00:00
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....
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2018.09.003
更新日期:2019-04-01 00:00:00
abstract::In response to the COVID-19 pandemic, the medical education community was forced to transition to the virtual space seemingly overnight, with little time to prepare. As such, many medical educators are actively seeking ways to improve delivery of online content and utilize features of different technologies. This View...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2020.11.009
更新日期:2021-01-01 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