A5055793967- Healthcare Policy and Management
- Emergency and Acute Care Studies
- Food Security and Health in Diverse Populations
- Primary Care and Health Outcomes
- Child and Adolescent Health
- Homelessness and Social Issues
- Global Health Care Issues
- Heart Failure Treatment and Management
- Adolescent and Pediatric Healthcare
- Geriatric Care and Nursing Homes
- Healthcare cost, quality, practices
- Radiation Dose and Imaging
- Childhood Cancer Survivors' Quality of Life
- Ultrasound in Clinical Applications
- Child Nutrition and Water Access
- Airway Management and Intubation Techniques
- Trauma and Emergency Care Studies
- Tracheal and airway disorders
- Asthma and respiratory diseases
- Gender, Labor, and Family Dynamics
- Patient Satisfaction in Healthcare
- Infant Development and Preterm Care
- Esophageal and GI Pathology
- Radiology practices and education
- Innovations in Medical Education
Harvard Pilgrim Health Care
2019-2025
Harvard University
2019-2025
Boston Children's Hospital
2013-2025
RAND Corporation
2025
Yale New Haven Health System
2020-2022
Yale University
2016-2020
Yale New Haven Hospital
2019
Robert Wood Johnson Foundation
2016-2018
Boston Medical Center
2013-2017
Centers for Medicare and Medicaid Services
2015
Hospital readmission rates are increasingly used to assess quality. Little is known, however, about potential preventability of readmissions among children. Our objective was evaluate 30-day using medical record review and interviews.A cross-sectional study in 305 children (<18 years old) readmitted within 30 days a freestanding children's hospital between December 2012 February 2013. Interviews (N = 1459) were conducted with parents/guardians, patients (if ≥13 old), inpatient clinicians,...
<h3>Importance</h3> Diagnostic imaging is frequently performed as part of the emergency department (ED) evaluation children. Whether patterns differ by race and ethnicity unknown. <h3>Objective</h3> To evaluate racial ethnic differences in performance common ED studies to examine across diagnoses. <h3>Design, Setting, Participants</h3> This cross-sectional study evaluated visits patients younger than 18 years 44 US children’s hospital EDs from January 1, 2016, through December 31, 2019....
BACKGROUND AND OBJECTIVES: Fifteen percent of US children live in households with inadequate food. Children who are food insecure often experience worse physical, emotional, and developmental health outcomes. Authors previous studies have not examined the quality cost implications insecurity children. METHODS: This is a retrospective study 7959 nationally representative (aged 1–17 years) 2016 Medical Expenditure Panel Survey. Households were identified by ≥3 positive responses to 30-day,...
Food insecurity has been associated with the health care expenditures of individuals, but it can affect entire family. Evaluating relationship between food and family provides a better understanding financial implications interventions. Our primary objective was to evaluate association in one year (2016) expenditures—for all members, for children only, adults only—in next (2017). We also evaluated whether this varied across types insurance coverage within families: private, public, or mixed...
BACKGROUND AND OBJECTIVES: Delivering high-quality care to children living in rural areas can be challenging. Compared with nonrural children, often experience worse health outcomes. We assessed characteristics and hospitalizations of admitted US children’s hospitals 2012. METHODS: Retrospective cohort analysis 672190 admissions between January 1, 2012, December 31, 41 the Pediatric Health Information System database. ZIP codes were used assess patients’ rurality (by using Rural-Urban...
Student-run free clinics (SRFCs) provide service-learning opportunities for medical students and care to underserved patients. Few published studies, however, support that they high-quality care. In this study, the authors examined clinical impact of a student health educator program diabetic patients at an SRFC.In 2012, retrospectively reviewed electronic records who established Shade Tree Clinic in Nashville, Tennessee, between 2008 2011. They compared outcomes initial presentation clinic...
Children who experience high health care costs are increasingly enrolled in clinical initiatives to improve their and contain costs. Hospitalization is a significant cost driver. We describe hospitalization trends for children with highest annual inpatient (CHIC) identify characteristics associated persistently subsequent years.Retrospective study of 265 869 age 2 15 years ≥1 admission 2010 39 children's hospitals the Pediatric Health Information System. CHIC were defined as top 10% total (n...
There is increased awareness of radiation risks from computed tomography (CT) in pediatric patients. In emergency departments (EDs), evidence-based guidelines, improvements imaging technology, and availability nonradiating modalities have potentially reduced CT use.To evaluate changes over time hospital variation advanced use.This cross-sectional study assessed 26 082 062 ED visits by children younger than 18 years the Pediatric Health Information System administrative database January 1,...
Limitations in the quality of race-and-ethnicity information Medicare's data systems constrain efforts to assess disparities care among older Americans. Using demographic from standardized patient assessments may be an efficient way enhance accuracy and completeness systems, but it is critical first establish these as they prone inaccurate observer-reported or third-party-based information. This study evaluates patient-level included Outcome Assessment Information Set (OASIS) submitted by...
Diagnostic imaging overuse in children evaluated emergency departments (EDs) is a potential target for reducing low-value care. Variation practice patterns across Canada and the United States stemming from organization of care, payment structures, medicolegal environments may lead to differences between countries.
Primary care is an important setting to identify and support children who are eligible but not enrolled in the Supplemental Nutrition Assistance Program (SNAP) (the SNAP Gap), although there concern that these programs may be limited reach. We sought patterns of health use among unenrolled children. conducted a cross-sectional analysis 2021 Medical Expenditure Panel Survey. identified 975 eligible/nonenrolled with household incomes less than 200% federal poverty level. eligibility was...
Importance Medications for opioid use disorder (MOUD) are effective, but hospitalized people with (OUD) seldom receive MOUD while in the hospital or link treatment after. Objective To test whether an addiction-focused consultation service, Substance Use Treatment and Recovery Team (START), increases initiation during hospitalization linkage to follow-up care after discharge. Design, Setting, Participants This 1:1 randomized clinical trial grouped participants into START intervention usual...
<h3>Importance</h3> Lower rates of diagnostic imaging have been observed among Black children compared with White in pediatric emergency departments. Although the racial composition population served by each hospital differs, it is unclear whether this associated overall at level, and particular how may be difference between a given hospital. <h3>Objective</h3> To examine association diversity seen ED variation imaging. <h3>Design, Setting, Participants</h3> Cross-sectional analysis visits...
Many children's hospitals are actively working to reduce readmissions improve care and avoid financial penalties. We sought determine if pediatric readmission rates have changed over time. used data from 66 in the Inpatient Essentials Database including index hospitalizations January, 2010 through June, 2016. Seven‐day all cause (AC) potentially preventable (PPR) were calculated using 3M PPR software. Total condition‐specific quarterly AC generated for each hospital aggregate. included 4.52...
<h3>Importance</h3> The Affordable Care Act (ACA) sought to improve access and affordability of health insurance. Although most ACA policies targeted childless adults, the extent which these also impacted families with children remains unclear. <h3>Objective</h3> To examine changes in care–related financial burden for US before after was implemented based on income eligibility policies. <h3>Design, Setting, Participants</h3> Data used this cohort study were obtained from 2000-2017 Medical...
Importance Government and commercial health insurers have recently enacted policies to discourage nonemergent emergency department (ED) visits by reducing or denying claims for such using retrospective algorithms. Low-income Black Hispanic pediatric patients often experience worse access primary care services necessary preventing some ED visits, raising concerns about the uneven impact of these policies. Objective To estimate potential racial ethnic disparities in outcomes Medicaid...