A5021399659- Adolescent and Pediatric Healthcare
- Child and Adolescent Health
- Healthcare Policy and Management
- Childhood Cancer Survivors' Quality of Life
- Family and Disability Support Research
- Emergency and Acute Care Studies
- Child Nutrition and Feeding Issues
- Infant Development and Preterm Care
- Primary Care and Health Outcomes
- Pharmaceutical studies and practices
- Health Systems, Economic Evaluations, Quality of Life
- Pleural and Pulmonary Diseases
- COVID-19 and healthcare impacts
- Food Security and Health in Diverse Populations
- Family and Patient Care in Intensive Care Units
- COVID-19 and Mental Health
- Ultrasound in Clinical Applications
- Healthcare cost, quality, practices
- Chronic Disease Management Strategies
- Pregnancy and preeclampsia studies
- Cerebral Palsy and Movement Disorders
- Ethics and Legal Issues in Pediatric Healthcare
- Gestational Diabetes Research and Management
- Gastroesophageal reflux and treatments
- Neonatal Respiratory Health Research
University of Toronto
2016-2025
Hospital for Sick Children
2016-2025
SickKids Foundation
2016-2025
Institute for Clinical Evaluative Sciences
2016-2025
Public Health Ontario
2020-2025
McMaster University
2010-2024
University College London
2010-2024
Institute for Work & Health
2012-2024
Great Ormond Street Hospital
2010-2024
Manitoba Health
2021-2024
Health care use of children with medical complexity (CMC), such as those neurologic impairment or other complex chronic conditions (CCCs) and technology assistance (TA), is not well understood. The objective the study was to evaluate health utilization costs in a population-based sample CMC Ontario, Canada.Hospital discharge data from 2005 through 2007 identified CMC. Complete system were analyzed over subsequent 2-year period.The 15 771 hospitalized (0.67% Ontario); 10 340 (65.6%) had...
<h3>Context</h3>Early hospital readmission is emerging as an indicator of care quality. Some children with chronic illnesses may be readmitted on a recurrent basis, but there are limited data describing their rehospitalization patterns and impact.<h3>Objectives</h3>To describe the inpatient resource utilization, clinical characteristics, admission reasons patients recurrently to children's hospitals.<h3>Design, Setting, Patients</h3>Retrospective cohort analysis 317 643 (n = 579 504...
<h3>Objectives</h3>To profile the national prevalence of more medically complex children with special health care needs (CSHCN) and diversity caregiver challenges that their families confront.<h3>Design</h3>Secondary analysis 2005-2006 National Survey Children With Special Health Care Needs (unweighted n = 40 723).<h3>Setting</h3>United States–based population.<h3>Participants</h3>National sample CSHCN.<h3>Main Exposure</h3>More CSHCN were defined by incorporating components child family...
A small but growing population of children with medical complexity, many whom are covered by Medicaid, accounts for a high proportion pediatric health care spending. We first describe the expenditures complexity insured Medicaid across continuum. report increasingly large amount spending on hospital these children, relative to primary and home then present business case that estimates how cost savings might be achieved from potential reductions in emergency department use shows could...
To compare inpatient resource use trends for healthy children and with chronic health conditions of varying degrees medical complexity.
Public health measures to reduce the spread of COVID-19 have heightened distress among children and adolescents contributed a shift in delivery mental care services.
Children with special health care needs are believed to be susceptible inequities in and access. Within the group needs, there is a smaller of children medical complexity: who require services beyond what typically required by needs. We describe for complexity compared but without complexity, based on secondary analysis data from 2005–06 2009–10 National Survey Special Health Care Needs. The survey examines prevalence, service use, youth as reported their families. we examined were those...
Primary care medical homes may improve health outcomes for children with special healthcare needs (CSHCN), by improving coordination. However, community-based primary practices be challenged to deliver comprehensive coordination complex subsets of CSHCN such as complexity (CMC). Linking a tertiary center the community achieve cost effective and high quality CMC. The objective this study was evaluate clinics integrated center. A before- after-intervention design mixed...
<h3>Background:</h3> Limited data are available on adverse events among children admitted to hospital. The Canadian Paediatric Adverse Events Study was done describe the epidemiology of in hospital Canada. <h3>Methods:</h3> We performed a 2-stage medical record review at 8 academic pediatric centres and 14 community hospitals reviewed charts from patients April 2008 through March 2009, evenly distributed across 4 age groups (0 28 d; 29 365 > 1 5 yr 18 yr). In stage 1, nurses health...
Children with medical complexity (CMC) are a subset of children and youth special health care needs high resource use costs. Novel delivery models in which coordination other services to CMC provided focus national local policy initiatives. Current for can be grouped into 3 main categories: (1) primary care–centered models, (2) consultative- or comanagement-centered (3) episode-based models. Each model has unique advantages disadvantages. Evaluations these have demonstrated positive...
<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....
<h3>Background</h3> The transition from paediatric to adult care is associated with poor clinical outcomes, increased costs and low patient family satisfaction. However, little known about health system strategies streamline safeguard for youth transitioning services. Moreover, the needs of children are often excluded broader reform discussions, leaving this population especially vulnerable 'disintegration'. <h3>Objectives</h3> (1) To explore international policy profile paediatric-to-adult...
The transition from a pediatric to adult health care system is challenging for many youths with epilepsy and their families. Recently, the Ministry of Health Long-Term Care Province Ontario, Canada, created working group (TWG) develop recommendations process patients in Ontario. Herein we present an executive summary this work. TWG was composed multidisciplinary epileptologists, psychiatrists, family doctors academia community; neurologists nurses social workers programs; adolescent medicine...
Importance Children with medical complexity (CMC) have chronic conditions and high health needs may experience fragmented care. Objective To compare the effectiveness of a structured complex care program, Complex Care for Kids Ontario (CCKO), usual Design, Setting, Participants This randomized clinical trial used waitlist variation randomizing patients from 12 clinics in Ontario, Canada, over 2 years. The study was conducted December 2016 to June 2021. were identified based on clinic...
Importance Unintentional injury, suicide, and homicide are leading causes of death among young females. Teen pregnancy may be a marker adverse life experiences. Objective To evaluate the risk premature mortality from 12 years age onward in association with number teen pregnancies at pregnancy. Design, Setting, Participants This population-based cohort study was conducted all females alive April 1, 1991, to March 31, 2021, Ontario, Canada (the most populous province, which has universal...
The Medical Home model recommends that Children with Special Health Care Needs (CSHCN) receive a medical care plan, outlining the child's major issues and needs to assist coordination. While plans are primary component of effective coordination, creation maintenance is time, labor, cost intensive, desired content plan has not been studied. purpose this qualitative study was understand usefulness comprehensive by exploring perceptions parents health providers (HCPs) children complexity (CMC)....
Children with multiple chronic conditions (CMCC) are increasingly using hospital care. We assessed how much of US pediatric inpatient care is used by CMCC and which the key drivers use.