A5003135739- Child and Adolescent Health
- Streptococcal Infections and Treatments
- Food Security and Health in Diverse Populations
- Healthcare Policy and Management
- Emergency and Acute Care Studies
- Antimicrobial Resistance in Staphylococcus
- Innovations in Medical Education
- Migration, Health and Trauma
- Global Health Workforce Issues
- Pharmaceutical Practices and Patient Outcomes
- Antibiotic Use and Resistance
- Primary Care and Health Outcomes
- Child Nutrition and Feeding Issues
- Youth Substance Use and School Attendance
- Healthcare cost, quality, practices
- Cultural Competency in Health Care
- Adolescent and Pediatric Healthcare
- Family and Patient Care in Intensive Care Units
- Diversity and Career in Medicine
- Health Sciences Research and Education
- Clinical Reasoning and Diagnostic Skills
- Pharmaceutical studies and practices
- Drug-Induced Adverse Reactions
- Childhood Cancer Survivors' Quality of Life
- Health Systems, Economic Evaluations, Quality of Life
Baylor College of Medicine
2016-2025
Texas Children's Hospital
2014-2025
Pediatrics and Genetics
2021
Hospital Universitario de Gran Canaria Doctor Negrín
2014-2021
University of Massachusetts Chan Medical School
2021
Postdischarge treatment of acute osteomyelitis in children requires weeks antibiotic therapy, which can be administered orally or intravenously via a peripherally inserted central catheter (PICC). The catheters carry risk for serious complications, but limited evidence exists on the effectiveness oral therapy.To compare and adverse outcomes postdischarge therapy PICC route.We performed retrospective cohort study comparing osteomyelitis. Among hospitalized from January 1, 2009, through...
The Child Opportunity Index measures the structural neighborhood context that may influence a child’s healthy development. We examined relationships between and emergency department utilization. BACKGROUND AND OBJECTIVES (COI) is multidimensional measure of Our objective was to determine if COI associated with children’s (ED) utilization using national sample. METHODS This retrospective cohort study Pediatric Health Information Systems, database from 49 United States hospitals. analyzed...
BACKGROUND AND OBJECTIVE Addressing adverse social determinants of health is an upstream approach to potentially improve child outcomes and equity. We aimed determine if systematically screening referring for needs in hospitalized pediatric patients increased families’ enrollment publicly available resources. METHODS Randomized controlled trial at a large urban children’s hospital enrolled English-speaking caregivers 0 36 months age on the general pediatrics service from June 2016 July 2017....
To describe trends in national resource utilization for pediatric skin and soft tissue infection (SSTI) hospitalizations.This was a cross-sectional analysis of hospital discharges from 1997 to 2009 within the Healthcare Cost Utilization Project Kids' Inpatient Database children with isolated SSTIs. Outcomes examined included patient characteristics, number hospitalizations, including length stay (LOS), charges, performance incision drainage (I&D). Trends were assessed by using linear...
OBJECTIVE Child Opportunity Index (COI) measures neighborhood contextual factors (education, health and environment, social economic) that may influence child health. Such have been associated with hospitalizations for ambulatory care sensitive conditions (ACSC). Lower COI has higher utilization, yet association rehospitalization(s) ACSC remains unknown. Our objective is to determine the between rehospitalizations. METHODS Multicenter retrospective cohort study of children ages 0 17 years a...
BACKGROUND AND OBJECTIVES The American Board of Pediatrics requires that proposed changes to the duration pediatric subspecialty training must include a framework for competency assessment with measurement component. We analyzed clinical Entrustable Professional Activity (EPA) level supervision ratings across 3-year fellowships determine if trainees met minimum thresholds graduation after 2 years fellowship training. METHODS From spring 2019 through 2022, Clinical Competency Committees...
BACKGROUND AND OBJECTIVES Entrustable professional activities (EPAs) will be used for initial certification by the American Board of Pediatrics 2028. Less than half pediatric fellowships currently use EPAs assessment, yet all need to adopt them. Our objectives were identify facilitators and barriers implementation assess fellows determine fellowship program directors’ (FPD) perceptions Milestones. METHODS We conducted a survey FPDs from 15 subspecialties. EPA users asked about their EPAs,...
Studies supporta recent decline in public benefit enrollment among immigrant families. We aimed to describe health and resource use, barriers immigration-related fear families with undocumented parents compared without parents. also assess associations discontinuation of benefits deportation.We assessed immigration concerns Medicaid, Supplemental Nutrition Assistance Program (SNAP), Special for Women, Infants, Children (WIC) an 89-item anonymous, cross-sectional survey English-...
Objective: To describe factors associated with prolonged lengths of stay (LOS) and increased charges for pediatric skin soft tissue infection (SSTI) hospitalizations. Methods: This study was a cross-sectional analysis SSTI hospital discharges in 2009 within the Healthcare Cost Utilization Project Kids’ Inpatient Database. Outcomes were LOS (>75th percentile) percentile). Multivariate logistic regression controlling patient level conducted data to assess associations among variables....
Residents are on the front lines of medical care in academic institutions. Their daily interactions crucial to quality received by patients these settings, and thus, knowledge patient safety improvement is essential. The Accreditation Council for Graduate Medical Education requires all residents participate programs as part their residency training. To meet this need, we developed a curriculum pediatric residents.This describes four short modules focused improvement, safety, evidence-based...
Abstract Background Health disparities related to race, ethnicity, socioeconomic status, and insurance status impact quality, access, health outcomes for children. Medicaid is a proxy poverty restricted access care. The goal of this study was determine if there are discrepancies in the length cost hospitalizations between admissions covered by or commercial pediatric patients with cancer. Methods Childhood cancer‐related were identified from 2012 Kids Inpatient Database (KID) using...
Understanding the economics of pediatric liver transplantation (LT) is central to high-value care initiatives. We examined cost and resource utilization in LT nationally identify drivers hospital factors associated with greater total care. reviewed 3295 children (<21 y) receiving an from 2010 2020 Pediatric Health Information System study cost, both per service line, mortality, complications, utilization. To facilitate comparisons, patients were stratified into high-cost, intermediate-cost,...
Data on US caregiver perceptions coronavirus disease 2019 (COVID-19) and COVID-19 vaccination are limited. We identified trends in associations with vaccine hesitancy caregivers of hospitalized children.
BACKGROUND: High-cost hospitalizations (HCHs) account for a substantial proportion of pediatric health care expenditures. We aimed to (1) describe the distribution HCHs across hospital types caring children and (2) compare characteristics by type. METHODS: Cross-sectional analysis all in 2012 Kids’ Inpatient Database. were defined as costs &gt;$40 000 (94th percentile). Hospitals categorized children’s, small general, large general. RESULTS: Approximately 166 responsible 50.8% aggregate...
Background and Objective: Pertussis is a serious preventable childhood illness often necessitating hospitalization. The objective was to describe national trends in pediatric pertussis hospitalizations resource utilization factors associated with increased length of stay (LOS). Methods: This cross-sectional analysis the 1997 2009 Healthcare Cost Utilization Project Kids’ Inpatient Databases. We examined children (0–18 years) diagnosis pertussis. Primary outcomes were hospitalizations, LOS,...
The objective of this study was to describe the frequency invasive bacterial infections (IBIs) in young infants with skin and soft tissue (SSTIs) impact IBI evaluation on disposition, length stay (LOS), cost.This retrospective (2009-2014) cohort used data from 35 children's hospitals Pediatric Health Information System. We included younger than 60 days who presented an emergency department (ED) SSTI. Invasive infection defined as bacteremia/sepsis, bone/joint infection, or meningitis....
The incidence of staphylococcal scalded skin syndrome (SSSS) is rising, but current practice variation in diagnostic test use not well described. Our aim was to describe the children hospitalized with SSSS and determine associations patient outcomes.We performed a retrospective (2011-2016) cohort study aged 0 18 years from 35 children's hospitals Pediatric Health Information System database. Tests included blood culture, complete count, erythrocyte sedimentation rate, C-reactive protein...
Background: Communication is essential to building a trusting, clinician-patient relationship. Multiple studies have demonstrated the effects of experiential communication training on patient experience and provider well-being resiliency. To date, no described an organization-wide program for pediatric clinicians. The objective this study was evaluate impact pediatric-focused course satisfaction, self-efficacy, burnout. Methods: Texas Children’s Hospital, in collaboration with Academy...