A5050461097- Emergency and Acute Care Studies
- Asthma and respiratory diseases
- Child and Adolescent Health
- Family and Patient Care in Intensive Care Units
- Global Health Care Issues
- Healthcare Policy and Management
- Adolescent and Pediatric Healthcare
- Pharmaceutical studies and practices
- Health disparities and outcomes
- Infant Development and Preterm Care
- Health Systems, Economic Evaluations, Quality of Life
- Healthcare Technology and Patient Monitoring
- School Health and Nursing Education
- Respiratory and Cough-Related Research
- Childhood Cancer Survivors' Quality of Life
- Chronic Obstructive Pulmonary Disease (COPD) Research
- Food Security and Health in Diverse Populations
- Electronic Health Records Systems
- Mobile Health and mHealth Applications
- Healthcare cost, quality, practices
- Injury Epidemiology and Prevention
- Health, psychology, and well-being
- Patient-Provider Communication in Healthcare
- Medical Education and Admissions
- Neurological diseases and metabolism
Sheffield Teaching Hospitals NHS Foundation Trust
2023
Cincinnati Children's Hospital Medical Center
2012-2021
University of Cincinnati Medical Center
2016-2021
University of Cincinnati
2015-2020
Robert Wood Johnson Foundation
2015
University of Michigan
2015
University of Illinois Chicago
2010
BACKGROUND AND OBJECTIVES: Health care reform offers a new opportunity to address child health disparities. This study sought characterize racial differences in pediatric asthma readmissions with focus on the potential explanatory role of hardships that might be addressed future patient models. METHODS: We enrolled 774 children, aged 1 16 years, admitted for or bronchodilator-responsive wheezing population-based prospective observational cohort. The outcome was time readmission. Child race,...
To characterize whether single parent households are associated with pediatric asthma-related repeat healthcare utilization and to examine family-level psychosocial variables that may explain this relationship.We analyzed a prospective cohort of 526 children aged 1-16 years hospitalized for asthma or bronchodilator-responsive wheezing whose caregivers self-reported their marital status. Those reporting being "single" were considered the at-risk category. The outcome was (emergency room (ER)...
Asthma is the most common chronic condition of childhood. Hospitalizations and emergency department (ED) visits for asthma are more frequently experienced by minority children adolescents those with low socioeconomic status.To reduce asthma-related hospitalizations ED Medicaid-insured pediatric patients residing in Hamilton County, Ohio.From January 1, 2010, through December 31, 2015, a multidisciplinary team used quality-improvement methods care model to conduct interventions inpatient,...
We assessed whether geographic information available at the time of asthma admission predicts to reutilization (readmission or emergency department revisit).For a prospective cohort children hospitalized with in 2008 and 2009 Cincinnati, Ohio, we constructed social risk index from geocoded home addresses linked census tract extreme poverty high school graduation rates median values. examined associations caregiver report hardship.Thirty-nine percent patients reutilized within 12 months....
OBJECTIVE: The medical home likely has a positive effect on outpatient outcomes for children with asthma. However, no information is available regarding the impact of quality health care utilization after hospitalizations. We sought to explore relationship between and readmission risk in hospitalized asthma exacerbations. METHODS: enrolled 601 children, aged 1 16 years, an acute exacerbation at single pediatric facility that captures >85% all admissions 8-county area. Caregivers...
Strategies to improve pulmonary endothelial barrier function are needed reverse the devastating effects of vascular leak in acute respiratory distress syndrome. FTY720 is a pharmaceutical analogue potent barrier-enhancing phospholipid sphingosine 1-phosphate (S1P). decreases permeability by an incompletely characterised mechanism that differs from S1P. Here, we describe its barrier-promoting on intracellular signalling and junctional assembly formation human endothelium. Permeability...
Background Stress caused by hospitalisations and transition periods can place patients at a heightened risk for adverse health outcomes. Additionally, transitions to home may be experienced in different ways families with resources support systems. Such differences perpetuate postdischarge disparities. Objective We sought determine, qualitatively, how the hospitalisation experiences differed among of varying socioeconomic status (SES). Methods Focus groups individual interviews were held...
Families often struggle after discharge of a child from the hospital. Postdischarge challenges can lead to increased use urgent health care services.
BACKGROUND AND OBJECTIVE: Asthma heterogeneity causes difficulty in studying and treating the disease. We built a comprehensive statewide repository linking questionnaire medical record data with health outcomes to characterize variability of clinical practices at Ohio children’s hospitals for treatment hospitalized asthma. METHODS: Children 6 participating asthma exacerbation or reactive airway disease aged 2 17 were eligible. Medical, social, environmental histories past admissions...
Objective: The objective was to determine the effect of an electronic asthma-specific inpatient history and physical (H&P) template on documented improvements in care plans. Methods: This a before-after comparison plan documentation following implementation new H&P template. implemented May 2011. A retrospective review health record completed for 304 consecutive patients (2–16 years age) admitted asthma June September 2010 242 Elements reviewed included severity classification,...
Background: Community-acquired pneumonia is a leading cause of pediatric morbidity. Administrative data are often used to conduct comparative effectiveness research (CER) with sufficient sample sizes enhance detection important outcomes. However, such studies prone misclassification errors because the variable accuracy discharge diagnosis codes.
Community pharmacies may be positioned for an increased role in population health. We sought to develop a population-level measure of asthma medication fills and assess its relationship asthma-related utilization.We conducted retrospective, ecological study (2010-2012). Medication data from chain (n = 27) within 1 county were used calculate Pharmacy-level Asthma Ratio (Ph-AMR), defined as controller divided by plus rescue fills. Higher values are superior because they indicate more compared...
In our previous work, providing medications in-hand at discharge was a key strategy to reduce asthma reutilization (readmissions and emergency revisits) among children in large, urban county. We sought spread this work satellite hospital an adjacent A initial barrier the lack of outpatient pharmacy on site, so we determine if partnership with community pharmacies could improve percentage patients discharge, thus decreasing reutilization.A multidisciplinary team partnered pharmacies. Using...
BACKGROUND: Large-scale, multisite studies in which researchers evaluate patient- and systems-level factors associated with pediatric asthma exacerbation outcomes are lacking. We sought to investigate patient-level risks system-level practices related physiologic readiness for discharge (PRD) the prospective Ohio Pediatric Asthma Repository. METHODS: Participants were children ages 2 17 years admitted an Repository hospital exacerbation. Demographics, disease characteristics, individual...
Abstract Aim To describe paediatric postdischarge concerns manifesting in the first 96 hr after hospital discharge. Design Analysis of nursing documentation generated as part a randomized controlled trial evaluating effect nurse home visit on healthcare re‐use. Methods We analysed records 651 children (age <18) hospitalized at large Midwestern children's 2015 and 2016 who were enrolled trial. Registered nurses documented structured fields free‐text notes records. Descriptive statistics...
BACKGROUND: The Hospital to Home Outcomes (H2O) trial was a 2-arm, randomized controlled that assessed the effects of nurse home visit after pediatric hospital discharge. Children intervention had higher 30-day postdischarge reutilization rates compared with those standard We sought understand perspectives on why visits resulted in and elicit suggestions how improve future interventions. METHODS: qualitative input using focus groups interviews from stakeholder groups: parents, primary care...
Our grant from the Patient-Centered Outcomes Research Institute (PCORI) focused on use of nurse home visits postdischarge for primarily pediatric hospital medicine patients. While our team recognized importance engaging parents and other stakeholders in study, project was one first funded to address transitions care issues patients without chronic illness; little evidence existed about how engage acute longitudinally.This manuscript describes we used both a short-term feedback model...