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 clinic scheduling models: a traditional fixed-day clinic and a variable-day clinic in which resident clinic days vary each week to accommodate resident schedules. METHODS:The setting for our study was a large university resident continuity clinic. We analyzed 111 resident schedules and 1113 visits by children aged younger than 1 year during 2 periods: July 2007 to December 2007, when residents were scheduled by using a variable-day clinic model, and July 2008 to December 2008, when a fixed-day model was used. We compared the number of clinic sessions per resident and continuity of care. We used the usual provider of care definition of continuity: the proportion of visits in which a patient is seen by his or her primary resident. A multivariable logistic regression was used to model the relationship between patient continuity of care and clinic structure (fixed-day vs variable-day), resident level, patient age, and appointment type. RESULTS:The number of clinics per resident during a 6-month period was higher using variable-day scheduling (19.6 vs 16.2; P < .01), whereas continuity of care was lower (0.54 vs 0.61; P = .01) In the multivariate model, continuity of care was significantly higher under the fixed-day model (odds ratio 1.40; P < .01). CONCLUSIONS:Scheduling residents for continuity clinic on variable days results in lower patient continuity of care despite increased resident time in clinic.
journal_name
Acad Pediatrjournal_title
Academic pediatricsauthors
Lerner CF,Chung PJdoi
10.1016/j.acap.2009.11.002subject
Has Abstractpub_date
2010-03-01 00:00:00pages
119-23issue
2eissn
1876-2859issn
1876-2867pii
S1876-2859(09)00303-9journal_volume
10pub_type
杂志文章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 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: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 assess primary care providers' current reminder/recall practices, preferences for collaboration with health departments in reminder/recall efforts, attitudes toward practice-based and population-based reminder/recall, and experiences with a population-based reminder/recall intervention. METHODS:Providers ...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2013.09.003
更新日期:2014-01-01 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:BACKGROUND AND OBJECTIVE:Patients with limited English proficiency (LEP) experience worse health care outcomes compared to English proficient (EP) patients, and professional interpretation is underutilized in clinical settings. The objectives of this study were to describe patterns of interpreter use in a pediatric eme...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2019.07.006
更新日期:2019-01-01 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: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:Almost one-half of all pediatric gastrostomy tube insertions are accompanied by a fundoplication, yet little is understood about the surgical decision-making for these procedures. The objective of this study was to examine the decision-making process of surgeons about whether to perform a fundoplication in ch...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2012.07.006
更新日期:2012-11-01 00:00:00
abstract:OBJECTIVE:Pediatricians have regular opportunities to perform screening dental examinations on young children and to educate families on preventive oral health. We sought to assess pediatricians' current attitudes and practices related to oral health of children 0-3 years old. METHODS:A Periodic Survey of Fellows, foc...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2009.09.016
更新日期:2009-11-01 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: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:Literacy promotion is a pediatric standard of care in which clinicians provide guidance on shared reading. Latino parents are more likely to hear advice to read with children but are less likely to do so. We sought to understand literacy promotion from the perspective of Latino parents and to identify facilit...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2020.08.003
更新日期:2020-01-01 00:00:00
abstract:OBJECTIVE:The number of pediatric Global Health (GH) tracks has more than doubled in less than 10 years. The goal of this study was to describe the characteristics of the pediatric GH tracks to identify commonalities and differences in track structure, funding, and education. In addition, we also identified demographic...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2018.03.009
更新日期:2018-08-01 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: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:OBJECTIVE:To understand why families enroll in and disenroll from Children's Health Insurance Program (CHIP), their experience with the CHIP application and renewal process, and the insurance coverage of their children after disenrolling. METHODS:We conducted a large household telephone survey in 2012 of CHIP enrollee...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2015.02.013
更新日期:2015-05-01 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:BACKGROUND:Given the high prevalence of asthma and obesity in minority children, there is a need to identify targets for intervention to decrease the impact of these conditions on children's functioning in this high-risk group. OBJECTIVE:To examine in urban children with persistent asthma, 1) differences in asthma ind...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2019.07.001
更新日期:2020-01-01 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:OBJECTIVE:To determine the proportion of abstracts submitted to the 2010 Pediatric Academic Societies (PAS) meeting that were exclusively qualitative, and to examine whether these abstracts were more or less likely than all others to be designated as platform, poster, or publish only. METHODS:The database of abstracts...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2013.01.007
更新日期:2013-03-01 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 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: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: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::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 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 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: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