A5046578319- Emergency and Acute Care Studies
- Healthcare Policy and Management
- Child and Adolescent Health
- Adolescent and Pediatric Healthcare
- Hospital Admissions and Outcomes
- Childhood Cancer Survivors' Quality of Life
- Child and Adolescent Psychosocial and Emotional Development
- Infant Development and Preterm Care
- Primary Care and Health Outcomes
- Pneumonia and Respiratory Infections
- Healthcare Systems and Technology
- Family and Patient Care in Intensive Care Units
- Palliative Care and End-of-Life Issues
- COVID-19 and healthcare impacts
- Ethics and Legal Issues in Pediatric Healthcare
- HIV/AIDS Research and Interventions
- Patient-Provider Communication in Healthcare
- Heart Failure Treatment and Management
- Family and Disability Support Research
- Suicide and Self-Harm Studies
- Respiratory viral infections research
- Maternal Mental Health During Pregnancy and Postpartum
- Neonatal Respiratory Health Research
- Patient Satisfaction in Healthcare
- Child Welfare and Adoption
Dartmouth Institute for Health Policy and Clinical Practice
2016-2025
Dartmouth–Hitchcock Medical Center
2016-2025
Dartmouth College
2018-2025
Children's Hospital at Dartmouth Hitchcock
2018-2025
Dartmouth Health
2023-2024
Dartmouth Psychiatric Research Center
2023-2024
American Academy of Pediatrics
2021
Cornell University
2021
Weill Cornell Medicine
2021
Memorial Hospital
2020
BACKGROUND Children may be hospitalized at general hospitals or freestanding children's hospitals. Knowledge about how inpatient care differs these is important to inform national research and quality efforts. OBJECTIVE To describe the volume characteristics of pediatric hospitalizations acute in United States. DESIGN, PATIENTS, AND SETTING Cross‐sectional study States among children <18 years, excluding in‐hospital births, using Healthcare Cost Utilization Project's 2012 Kids' Inpatient...
Qualitative research methods explore and provide deep contextual understanding of real world issues, including people's beliefs, perspectives, experiences. Whether through analysis interviews, focus groups, structured observation, or multimedia data, qualitative offer unique insights in applied health services that other approaches cannot deliver. However, many clinicians researchers hesitate to use these methods, might not them effectively, which can leave relevant areas inquiry...
Importance Approximately 1 in 6 youth the US have a mental health condition, and suicide is leading cause of death among this population. Recent national statistics describing acute care hospitalizations for conditions are lacking. Objectives To describe trends pediatric between 2009 2019, to compare utilization non–mental hospitalizations, characterize variation across hospitals. Design, Setting, Participants Retrospective analysis 2009, 2012, 2016, 2019 Kids’ Inpatient Database, nationally...
National health care policy recommends that patients and families be actively involved in discharge planning. Although children with medical complexity (CMC) account for more than half of pediatric readmissions, scalable, family-centered methods to effectively engage CMC planning are lacking. We aimed systematically examine the scope preferences, priorities, goals parents regarding hospital-to-home transitions ascertain providers' perceptions families' transitional needs.
This study estimates the frequency and duration of boarding for pediatric mental health conditions at US acute care hospitals describes hospital resources available to support youths during boarding.
Children with medical complexity (CMC) have substantial health care needs and frequently experience poor quality. Understanding the population prevalence associated can inform clinical public initiatives.To estimate of CMC using open-source pediatric algorithms, evaluate performance these algorithms in predicting utilization in-hospital mortality, identify associations between as defined by outcomes.This retrospective cohort study used all-payer claims data from Colorado, Massachusetts, New...
National analyses suggest that approximately 1 in 5 US hospitals closed their pediatric units between 2008 and 2018. The extent to which hospitalizations at general rural urban communities decreased during this period is not well understood.To describe changes the number proportion of costs teaching, nonteaching, vs freestanding children's from 2009 2019; estimate providing inpatient care; characterize clinical complexity.This study a retrospective cross-sectional analysis 2009, 2012, 2016,...
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<h3>Importance</h3> Knowledge of health outcomes among opioid-exposed infants is limited, particularly for those not diagnosed with neonatal opioid withdrawal syndrome (NOWS). <h3>Objectives</h3> To describe infant mortality and identify how risk differs in without a diagnosis NOWS compared exposure. <h3>Design, Setting, Participants</h3> A retrospective cohort study maternal-infant dyads was conducted, linking care claims vital records births from January 1, 2010, to December 31, 2014,...
Pediatric hospital medicine (PHM) established a new model of care for hospitalized children in the United States nearly 3 decades ago. In that time, field experienced rapid growth while distinguishing itself through contributions to medical education, quality improvement, clinical and health services research, patient safety, system leadership. Hospital systems have also invested using in-house pediatricians manage various inpatient settings as acuity has accelerated. National PHM leaders...
Acute care hospitals increasingly provide for youth experiencing mental health crises while they await transfer psychiatric hospitalization. To inform quality improvement efforts, we aimed to characterize hospitalists' perceptions of during pediatric boarding and their experiences moral distress in caring this population.In March 2021, conducted a web-based survey hospitalists who participate the Pediatric Research Inpatient Settings (PRIS) network. Closed- open-ended questions queried...
Abstract Purpose Children with medical complexity (CMC) may be at increased risk of rural–urban disparities in health care delivery given their multifaceted needs, but these are poorly understood. This study evaluated to CMC and determined whether Medicaid coverage, co‐occurring disability, community poverty modified the effects rurality on delivery. Methods retrospective cohort 2012–2017 all‐payer claims data from Colorado, Massachusetts, New Hampshire included <18 years. Health measures...
ABSTRACT Introduction Military Health System (MHS)-insured newborns receive care in military and civilian hospitals. Differences delivery location corresponding payment schemas raise questions regarding possible health system effects on utilization outcomes. We hypothesize that newborn clinical outcomes differ between hospitals the differences may be more pronounced among lower risk (i.e., late preterm non-preterm infants). Material Methods The cohort comprised live births captured DoD Birth...
Importance Pregnant women with disabilities are at higher risk of poor pregnancy and birth outcomes. Different methods for identifying disability may affect estimates health disparities in this population. Objective To compare outcomes among pregnant using different ways maternal disability. Design, Setting, Participants Retrospective cohort study linked vital records newborn claims Medicaid-insured live births from January 2010 to December 2014 Texas. Data analysis was conducted October...
BACKGROUND AND OBJECTIVES Children with medical complexity (CMC) are at substantially increased risk for adverse health outcomes and mortality, justifying programs policies to support their specialized needs. To inform such efforts, this study estimated the cumulative incidence of CMC-defining diagnoses by age 60 months in a cohort live births among US military families measured associations between birth these diagnoses. METHODS This retrospective analyzed Department Defense Birth Infant...
BACKGROUND: Transitions between sites of care are inherent to all hospitalizations, yet we lack pediatric-specific transitions-of-care quality measures. We describe the development and validation new measures obtained from medical record data. METHODS: After an evidence review, a multistakeholder panel prioritized by using RAND/University California, Los Angeles modified Delphi method. Three were endorsed, operationalized, field-tested at 3 children’s hospitals 2 community hospitals:...
To identify factors associated with referral and enrollment in early intervention (EI) for infants neonatal abstinence syndrome (NAS).We conducted a retrospective cohort study of 256 born NAS (2006-2013) at tertiary care hospital (Springfield), Massachusetts, linking maternal-infant birth hospitalization records Department Public Health EI records. We calculated the percent retained each step process over first 3 years life. separate multivariable logistic regression analyses to...
There is an urgent need to prepare pediatricians care for children with behavioral and mental health (B/MH) conditions. In this study, we evaluate the perceived competence of pediatric residents recent graduates in assessment treatment B/MH conditions, characterize variation across residency programs, identify program characteristics associated high competence.Cross-sectional survey applicants initial certifying examination pediatrics. Questions were focused on (1) who should be competent...
To examine inequities in pain assessment and management of hospitalized children with limited English proficiency (LEP) as assessed by (1) self-reported prevalence intensity, (2) nurse-documented assessments analgesia.A cross-sectional survey parent proxies examined preferred language prevalence, etiology; subsequent electronic medical record chart review demographics, scores, analgesia prescribed for aged ≤21 years at a tertiary care children's hospital. The primary outcome was difference...