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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
51 to 75 of 1562 Research Studies DisplayedCavallaro SC, Michelson KA, D'Ambrosi G
Critical revisits among children after emergency department discharge.
This retrospective study’s objectives were to determine the rate of critical emergency department (ED) revisits among children discharged from the ED and to identify factors associated with critical revisits. Using the HCUP State ED Databases (SEDD) and State Inpatient Databases (SID), researchers examined data from six states, including patients under 21 years old. The findings indicated that critical ED revisits after discharge were uncommon and patient death within three days of ED discharge were rare; patients with complex chronic conditions were more likely to have a critical ED revisit. The researchers concluded that future research should focus on understanding higher risk among patients with asthma or a history of complex chronic conditions.
AHRQ-funded; HS026503.
Citation: Cavallaro SC, Michelson KA, D'Ambrosi G .
Critical revisits among children after emergency department discharge.
Ann Emerg Med 2023 Nov; 82(5):575-82. doi: 10.1016/j.annemergmed.2023.06.006..
Keywords: Healthcare Cost and Utilization Project (HCUP), Children/Adolescents, Emergency Department, Hospital Discharge
Winer JC, Richardson T, Berg KJ
Effect modifiers of the association of high-flow nasal cannula and bronchiolitis length of stay.
In hospitalized children with bronchiolitis, the use of High-flow nasal cannula (HFNC) therapy is related with a longer length of stay (LOS) when used outside of the ICU. The purpose of this study was to explore the relationship between HFNC and LOS to determine if demographic and clinical factors modify the effect of HFNC usage on LOS. Of 8,060 included patients, 27.0% received HFNC during admission. The study found that age group, weight, complex chronic condition, initial tachypnea, initial desaturation, and ICU services were significantly related with LOS. The effect of HFNC on LOS varied among hospitals (P < .001), with the estimated increase in LOS ranging from 32% to 139%. 1- to 6-month-old infants, patients without initial desaturation, and patients without ICU services had the highest relationship between HFNC and LOS, respectively.
AHRQ-funded; HS026006.
Citation: Winer JC, Richardson T, Berg KJ .
Effect modifiers of the association of high-flow nasal cannula and bronchiolitis length of stay.
Hosp Pediatr 2023 Nov; 13(11):1018-27. doi: 10.1542/hpeds.2023-007295..
Keywords: Children/Adolescents, Respiratory Conditions, Hospitalization
Molloy MJ, Auger KA, Hall M
Epidemiology and severity of illness of MIS-C and Kawasaki Disease during the COVID-19 pandemic.
Researchers sought to understand the illness severity of multisystem inflammatory syndrome in children (MIS-C) compared with Kawasaki disease (KD) and to evaluate changes in MIS-C illness severity over time during the coronavirus pandemic. Data on the hospitalization of children with MIS-C and KD were taken from the Pediatric Health Information System administrative database. The results showed a higher proportion of hospitalizations with shock for MIS-C compared with KD, but a significant decrease in the odds of shock in MIS-C patients was observed over time; MIS-C was a source of lower morbidity than KD as the pandemic progressed. The researchers concluded that their findings provide evidence that MIS-C is a distinct condition from KD.
AHRQ-funded; HS026763; HS028102.
Citation: Molloy MJ, Auger KA, Hall M .
Epidemiology and severity of illness of MIS-C and Kawasaki Disease during the COVID-19 pandemic.
Pediatrics 2023 Nov 1; 152(5). doi: 10.1542/peds.2023-062101..
Keywords: Children/Adolescents, COVID-19
Kang-Yi CD, Kuriyan A, Kinkler G
Generating actionable evidence for school-based mental health service delivery: public-academic partnership based evaluations.
This paper reported the key findings of evaluations of Philadelphia's school mental health programs reimbursable through Medicaid billing since 2008. The evaluations included acute mental health service use of children who received school-based care and Medicaid expenditure, children's behaviors to measure school mental health providers' performance, and effects of school mental health programs on children's behavioral health functioning, school outcomes, and other service usage. The paper discussed how programs have been refined based on evaluation results, and shared lessons learned for successful public-academic partnership-based evaluations.
AHRQ-funded; HS026862.
Citation: Kang-Yi CD, Kuriyan A, Kinkler G .
Generating actionable evidence for school-based mental health service delivery: public-academic partnership based evaluations.
Community Ment Health J 2023 Nov; 59(8):1588-600. doi: 10.1007/s10597-023-01147-5..
Keywords: Children/Adolescents, Behavioral Health, Healthcare Delivery, Community-Based Practice
Luo BT, Barton HJ, Wooldridge AR
Human factors engineering for the pediatric hospitalist.
The authors summarized how human factors engineering (HFE) can provide a framework and tools to help understand and improve complex care processes and resulting outcomes. They offered examples of HFE's application to pediatric hospital medicine, highlighted an HFE-based framework, provided tools for leveraging this model, and listed resources for those interested in learning more about HFE.
AHRQ-funded; HS027214.
Citation: Luo BT, Barton HJ, Wooldridge AR .
Human factors engineering for the pediatric hospitalist.
Hosp Pediatr 2023 Nov; 13(11):e365-e70. doi: 10.1542/hpeds.2023-007258..
Keywords: Children/Adolescents, Hospitals, Provider: Clinician
Vasan A, Kyle MA, Venkataramani AS
Inequities in time spent coordinating care for children and youth with special health care needs.
The purpose of this cross-sectional study was to examine sociodemographic inequities in time spent coordinating care for children and youth with special health care needs (CYSHCN) and examine the relationship between time spent coordinating care and forgone medical care. The study utilized 2018-2020 data from the National Survey of Children's Health, which included 102,740 children across all 50 states. The researchers characterized the time spent coordinating care for children with less complex special health care needs (SHCN) (managed through medications) and more complex SHCN (resulting in functional limitations or requiring specialized therapies). Race-, ethnicity-, income-, and insurance-based differences in time spent coordinating care among CYSHCN were examined, and multivariable logistic regression was utilized to explore the relationship between time spent coordinating care and forgone medical care. The study found that over 40% of caregivers of children with more complex SHCN reported spending time coordinating their children's care each week. CYSHCN whose caregivers spent 5 hours per week or more on care coordination were disproportionately Hispanic, low-income, and publicly insured or uninsured. Increased time spent coordinating care was related with an increasing probability of forgone medical care.
AHRQ-funded; HS028555.
Citation: Vasan A, Kyle MA, Venkataramani AS .
Inequities in time spent coordinating care for children and youth with special health care needs.
Acad Pediatr 2023 Nov-Dec; 23(8):1526-34. doi: 10.1016/j.acap.2023.03.002..
Keywords: Children/Adolescents, Care Coordination, Vulnerable Populations, Disparities
Heintzman J, Springer R, Marino M
Latino adolescent-mother language concordance, neighborhood deprivation, and vaccinations in community health centers.
Researchers examined the association between adolescent-mother language concordance and neighborhood social deprivation with adolescent vaccination completion in order to understand social/family factors related to Latino adolescent vaccination. They used a multistate, EHR-based dataset of community health center patients to compare three Latino groups; their sample included over 56,000 adolescent-mother dyads. Their findings indicated that English-preferring adolescents with Spanish-preferring mothers had the highest completion rates. The researchers concluded that future studies could attempt to understand what advantage this language dyad may have in adolescent vaccination completion.
AHRQ-funded; HS025962.
Citation: Heintzman J, Springer R, Marino M .
Latino adolescent-mother language concordance, neighborhood deprivation, and vaccinations in community health centers.
Matern Child Health J 2023 Nov; 27(11):2026-37. doi: 10.1007/s10995-023-03742-0..
Keywords: Racial and Ethnic Minorities, Community-Based Practice, Vaccination, Children/Adolescents, Vulnerable Populations, Social Determinants of Health
Kieren MQ, Kelly MM, Garcia MA
Parent experiences with the process of sharing inpatient safety concerns for children with medical complexity: a qualitative analysis.
The objective of this study was to describe the process of identifying and reporting inpatient safety concerns from the perspective of parents of children with medical complexity (CMC). Researchers conducted a secondary analysis of qualitative data from semi-structured interviews with English and Spanish-speaking parents of CMC at two tertiary children's hospitals. The parents described a multi-step process of reporting their safety concerns and a spectrum of staff response and validation. The researchers concluded that their findings could inform family-centered interventions that support safety concern reporting in the inpatient setting.
AHRQ-funded; HS025781.
Citation: Kieren MQ, Kelly MM, Garcia MA .
Parent experiences with the process of sharing inpatient safety concerns for children with medical complexity: a qualitative analysis.
Acad Pediatr 2023 Nov-Dec; 23(8):1535-41. doi: 10.1016/j.acap.2023.06.008..
Keywords: Children/Adolescents, Patient Safety, Inpatient Care, Chronic Conditions
Beck AF, Wymer L, Pinzer E
Reduced prevalence of childhood asthma after housing renovations in an underresourced community.
This study’s goal as to determine whether housing renovations affect the prevalence of asthma in an underresourced community. Between 2010 and 2012, the Fay Apartments (~800 units) in Cincinnati, Ohio, were renovated to "green building" standards and renamed the Villages at Roll Hill. Asthma prevalence among 7-year-olds was determined by accessing Ohio Medicaid data for the years 2013 to 2021. Average prevalence of asthma among 7-year-olds averaged 12.7% in the first 6 years after the renovations (2013-2018). But in postrenovation years 7-9 (2019-221), average prevalence of asthma had dropped to 5.9%.
AHRQ-funded; HS027996.
Citation: Beck AF, Wymer L, Pinzer E .
Reduced prevalence of childhood asthma after housing renovations in an underresourced community.
J Allergy Clin Immunol Glob 2023 Nov; 2(4):1-4. doi: 10.1016/j.jacig.2023.100143..
Keywords: Children/Adolescents, Asthma, Respiratory Conditions, Vulnerable Populations, Social Determinants of Health
Keith A, Jenkins TC, O'Leary S
Reducing length of antibiotics for children with ear infections: protocol for a cluster-randomized trial in the USA.
The objective of the planned study described in this article will be to evaluate two low-cost interventions to increase guideline-concordant antibiotic durations in children with acute otitis media (AOM). The authors will explore differences in implementation effectiveness by patient population, clinician type, clinical setting, and organization as well as by intervention type. They will also conduct formative qualitative interviews with clinicians and administrators and focus groups with the parents of patients. The results of the study will provide a framework for healthcare systems to address the problem of excessive durations of therapy for AOM and to inform national antibiotic stewardship policy development.
AHRQ-funded; HS029153.
Citation: Keith A, Jenkins TC, O'Leary S .
Reducing length of antibiotics for children with ear infections: protocol for a cluster-randomized trial in the USA.
J Comp Eff Res 2023 Nov; 12(11):e230088. doi: 10.57264/cer-2023-0088..
Keywords: Children/Adolescents, Antibiotics, Medication, Ear Infections
Woods-Hill CZ, Koontz DW, Colantuoni EA
Sustainability of the Bright STAR diagnostic stewardship program to reduce blood culture rates among critically ill children.
From 2017 to2020, 14 pediatric intensive care units (PICUs) participated in the Bright STAR (Testing Stewardship for Antibiotic Reduction) QI collaborative to reduce unnecessary blood cultures for PICU patients. The collaborative project found that 4 sites demonstrated a 33% decrease in blood culture rates and a 13% decrease in broad spectrum antibiotic use. The purpose of this current study was to assess whether sites sustained reduced blood culture rates after completion of the formal project. The study found that all sites had lower blood culture rates during the sustainability period when compared with the pre-implementation period. The blood culture rate increased 8% during the sustainability period compared with the postimplementation period but was 27% lower than during the pre-implementation period.
AHRQ-funded; HS025642.
Citation: Woods-Hill CZ, Koontz DW, Colantuoni EA .
Sustainability of the Bright STAR diagnostic stewardship program to reduce blood culture rates among critically ill children.
JAMA Pediatr 2023 Nov; 177(11):1234-37. doi: 10.1001/jamapediatrics.2023.3229..
Keywords: Children/Adolescents, Critical Care, Quality Improvement, Diagnostic Safety and Quality, Quality of Care
Mak A, Hwang R, Nace G
Trends in histrelin implantation at a pediatric tertiary care center.
This study investigated procedural outcomes and identified changing trends of utilization among patients undergoing histrelin implantation at a large pediatric tertiary care center over a 15 year period. A total of 746 patients underwent 1794 unique procedures, with 1364 placements/replacements and 430 removals. Procedures were performed in the clinic (60%), sedation unit (35%), and operating room (5%). A total of 14 patients had complications, including two patients that required early implant removal and one patient requiring antibiotics. 579 implants were placed for central precocious puberty (CPP) and 167 for gender dysphoria (GD). The cohort included 25.9% males and 74.1% females with mean age of implantation of 9.48 years. The GD cohort was comprised of 52.4% males and 47.6% females, compared to 18.3% males and 81.7% females in the CPP group. Significant difference was identified for mean age at placement by indication (CPP 8.65 years versus GD 12.34). New patient referrals and implant procedures increased significantly for patients over 14 years of age. Yearly frequency of patients receiving implants for CPP and GD increased significantly, with the proportion of GD patients increasing from 7% to 32%.
AHRQ-funded; HS026116.
Citation: Mak A, Hwang R, Nace G .
Trends in histrelin implantation at a pediatric tertiary care center.
J Surg Res 2023 Nov; 291:73-79. doi: 10.1016/j.jss.2023.05.019..
Keywords: Children/Adolescents
Opel DJ, Vo HH, Dundas N
Validation of a process for shared decision-making in pediatrics.
The purpose of this study was to explore a 4-step process for implementing shared decision-making (SDM) in pediatrics that involves assessing whether the decision includes greater than 1 medically reasonable choice; 2) if one choice has a favorable medical benefit-burden ratio compared to other choices; and 3) parents' preferences regarding the choices; and 4) calibrating the SDM approach based on other applicable characteristics of the decision. The researchers videotaped a sample of pediatric inpatient and outpatient engagements at a United States children's hospital. Clinicians within craniofacial, neonatology, oncology, pulmonary, pediatric intensive care, hospital medicine, and sports medicine service categories were eligible for participation. English-speaking parents of children who participated in inpatient family care conferences or outpatient problem-oriented encounters with participating clinicians were eligible. The researchers conducted individual post-encounter interviews with clinician and parent participants used video-stimulated recall to stimulate reflection of decision-making that took place during the engagement. The study included 30 videotaped encounters and 53 interviews and discovered that clinicians' and parents' experiences of decision-making confirmed each SDM step. There were differences in the interpretation of each step and, depending on specific decisional contexts, a need for flexibility in implementing the process.
AHRQ-funded; HS026994.
Citation: Opel DJ, Vo HH, Dundas N .
Validation of a process for shared decision-making in pediatrics.
Acad Pediatr 2023 Nov-Dec; 23(8):1588-97. doi: 10.1016/j.acap.2023.01.007..
Keywords: Shared Decision Making, Children/Adolescents
Oke I, Slopen N, Hunter DG
Vision testing for adolescents in the US.
The purpose of this cross-sectional study was to characterize patterns in vision testing as a function of age among United States adolescents and identify sociodemographic factors related with vision testing. The researchers utilized data from 24,752 adolescent children (aged 12 to <18 years) from the 2018-2019 National Survey of Children's Health, a nationally representative survey of the noninstitutionalized United States pediatric population. The primary outcome of the study was the caregiver report of vision testing within the last 12 months. Vision testing in any setting within the previous year was reported by caregivers of 18,621 adolescents. Vision testing was reported to have occurred at an eye clinic in 13,323 participants, at a primary care clinic in 5,230 participants, at a school in 2,594 participants, and at a health center in 635 participants. The rate of adolescents reported to have vision tested decreased with age due to a decrease in testing in primary care and school settings. After adjusting for age and sex, there were lower odds of vision testing reported for adolescents who were uninsured vs insured, had caregivers with less than vs greater than high school education, and were from a family born outside vs inside the United States.
AHRQ-funded; HS000063.
Citation: Oke I, Slopen N, Hunter DG .
Vision testing for adolescents in the US.
JAMA Ophthalmol 2023 Nov; 141(11):1068-72. doi: 10.1001/jamaophthalmol.2023.4475..
Keywords: Children/Adolescents, Eye Disease and Health, Screening
Oke I, Nihalani BR, VanderVeen DK
Axial length and corneal curvature of normal eyes in the first decade of life.
The study aimed to establish normative curves for axial length and corneal curvature in children aged 0 to 10 years without ocular pathology. Measurements from 100 children revealed median axial length increasing from 20.6 mm at age one to 23.1 mm at age ten, while median average keratometry decreased from 44.1 D to 43.5 D over the same period. Normative charts were developed to aid in identifying abnormal eye measurements and managing conditions like glaucoma or cataract.
AHRQ-funded; HS000063.
Citation: Oke I, Nihalani BR, VanderVeen DK .
Axial length and corneal curvature of normal eyes in the first decade of life.
Eur J Ophthalmol 2023 Nov; 33(6):2217-21. doi: 10.1177/11206721231167643.
Keywords: Eye Disease and Health, Children/Adolescents
Dopp AR, Hunter SB, Godley MD
Comparing organization-focused and state-focused financing strategies on provider-level reach of a youth substance use treatment model: a mixed-method study.
This study’s goal was to compare organization-focused and state-focused financing strategies on their provider-level reach of a youth substance use treatment model. The authors evaluated financing strategies for the Adolescent Community Reinforcement Approach (A-CRA) EBP by comparing the two US federal grant mechanisms on organization-level A-CRA reach outcomes. Implementation of these A-CRA grants took place from 2006 to 2021. They used a quasi-experimental, mixed-method design to compare reach between treatment organizations funded by organization-focused versus state-focused grants (164 organizations, 35 states). Using administrative training records, they calculated reach as the per-organization proportion of trained individuals who received certification in A-CRA clinical delivery and/or supervision by the end of grant funding and also tested differences in certification rate by grant type. They also drew on interviews and surveys collected from the treatment organizations and (when relevant) interviews with state administrators to identify factors that influenced reach. Overall certification rates were 27 percentage points lower in state-focused versus organization-focused grants. They did not identify significant quantitative moderators of reach outcomes, but qualitative findings suggested certain facilitating factors were more influential for organization-focused grants (e.g., strategic planning) and certain barrier factors were more impactful for state-focused grants (e.g., states finding it difficult to execute grant activities).
AHRQ-funded; HS000046.
Citation: Dopp AR, Hunter SB, Godley MD .
Comparing organization-focused and state-focused financing strategies on provider-level reach of a youth substance use treatment model: a mixed-method study.
Implement Sci 2023 Oct 12; 18(1):50. doi: 10.1186/s13012-023-01305-z..
Keywords: Children/Adolescents, Substance Abuse, Behavioral Health
Vear KR, Esbrook E, Padley E
"Time and money and support": adolescents and young adults' perceived social and logistical support needs for safe abortion care.
This study’s objective was to understand what support adolescents and young adults need to access abortion amidst the changing legal landscape. A diverse nationwide sample of individuals aged 14-24 responded to a text message survey in July 2022 about the social and logistical support they would need for safe abortion access. Out of the sample of 638, there was a 78% response rate. Primary sources of social support from parents and friends were named by the respondents for potential abortion decisions. The respondents frequently cited money and transportation as logistical support needs for out-of-state abortion care.
AHRQ-funded; HS026369.
Citation: Vear KR, Esbrook E, Padley E .
"Time and money and support": adolescents and young adults' perceived social and logistical support needs for safe abortion care.
Contraception 2023 Oct; 126:110128. doi: 10.1016/j.contraception.2023.110128..
Keywords: Children/Adolescents, Young Adults, Maternal Care, Patient Safety, Access to Care
Georgette N, Michelson K, Monuteaux M
A temperature- and age-adjusted shock index for emergency department identification of pediatric sepsis.
The objective of this retrospective cohort study was to derive a temperature- and age-adjusted mean shock index (TAMSI) for early identification of sepsis and septic shock in children with suspected infection. Researchers analyzed data on children who presented with suspected infection to a single emergency department over a 10-year period. Test characteristics for the TAMSI cutoffs were compared with those for the Pediatric Advanced Life Support (PALS) tachycardia or systolic hypotension cutoffs. The results showed that TAMSI achieved a similar negative likelihood ratio and improved positive likelihood ratio compared with PALS vital sign cutoffs for the prediction of septic shock, but did not improve on PALS for sepsis prediction among children with suspected infection.
AHRQ-funded; HS026503.
Citation: Georgette N, Michelson K, Monuteaux M .
A temperature- and age-adjusted shock index for emergency department identification of pediatric sepsis.
Ann Emerg Med 2023 Oct; 82(4):494-502. doi: 10.1016/j.annemergmed.2023.03.026..
Keywords: Children/Adolescents, Emergency Department, Sepsis, Diagnostic Safety and Quality
Sequeria GM, Guler J, Reyes V
Adolescent and caregiver perspectives on receiving gender-affirming care in primary care.
The purpose of this study was to examine Transgender and gender-diverse (TGD) adolescents' and caregivers' experiences and perspectives about gender-affirming care delivery in pediatric primary care. Semi-structured, individual, virtual interviews were administered to TGD adolescents aged 14 to 17 and caregivers of TGD adolescents currently receiving gender-affirming medical care. A total of 15 adolescents and 18 caregivers (33 total participants) completed interviews. Adolescent participants primarily identified as transmasculine or trans male (73%), and caregiver participants were primarily mothers (83.3%). The study identified four themes, which included 1) barriers, such as microaggressions and poor psychosocial support, 2) benefits, such as existing trusted relationships with primary care providers (PCPs) and convenience, 3) improvement strategies, such as training and interdisciplinary collaboration, and 4) opportunities for integrating primary care and specialty gender-affirming care.
AHRQ-funded; HS026393.
Citation: Sequeria GM, Guler J, Reyes V .
Adolescent and caregiver perspectives on receiving gender-affirming care in primary care.
Pediatrics 2023 Oct 1; 152(4). doi: 10.1542/peds.2023-062210..
Keywords: Sex Factors, Children/Adolescents, Primary Care
Xie A, Koontz DW, Colantuoni EA
Application of participatory ergonomics to the dissemination of a quality improvement program for optimizing blood culture use.
The overuse of blood cultures in pediatric ICUs (PICUs) may lead to the unnecessary utilization of antibiotics and related resistance to antibiotics. The purpose of this study was to utilize a participatory ergonomics (PE) approach to disseminate a quality improvement (QI) program for optimizing blood culture use in PICUs and assess the dissemination process and its impact on blood culture reduction. The study found that overall, the participating sites were able to implement the program successfully and reduce their blood culture rates from 149.4 blood cultures per 1,000 patient-days/month before implementation to 100.5 blood cultures per 1,000 patient-days/month after implementation. Differences in the dissemination process, as well as in local interventions and implementation strategies, were observed across sites. Site-specific variations in the rates of blood cultures were weakly negatively associated with the number of preintervention interactions with the coordinating team but not associated with their experiences with the six domains of the dissemination process or their interventions.
AHRQ-funded; HS025642; HS025238.
Citation: Xie A, Koontz DW, Colantuoni EA .
Application of participatory ergonomics to the dissemination of a quality improvement program for optimizing blood culture use.
Jt Comm J Qual Patient Saf 2023 Oct; 49(10):529-38. doi: 10.1016/j.jcjq.2023.06.004..
Keywords: Quality Improvement, Quality of Care, Children/Adolescents, Intensive Care Unit (ICU)
Oke I, Gaier ED, Repka MX
Factors associated with visual acuity improvement with a binocular digital therapeutic for amblyopia.
Researchers combined data from amblyopic children enrolled in two prospective open-label pilot studies and a randomized trial of a binocular digital therapeutic to identify factors associated with positive response to amblyopia treatment. Treatment response was not found to be associated with age, severity of amblyopia, or prior treatment status. The researchers noted that although their findings may suggest broad efficacy for this treatment approach, further investigation in larger cohorts is needed to identify factors associated with treatment response.
AHRQ-funded; HS000063.
Citation: Oke I, Gaier ED, Repka MX .
Factors associated with visual acuity improvement with a binocular digital therapeutic for amblyopia.
J AAPOS 2023 Oct; 27(5):300-03. doi: 10.1016/j.jaapos.2023.06.007..
Keywords: Children/Adolescents, Eye Disease and Health
McCarthy IM, Raval MV
Price spillovers and specialization in health care: the case of children's hospitals.
The purpose of this study was to explore a possible differentiation effect in which patients perceive specialty hospitals as different from other hospitals, so that specialty hospitals effectively compete in a separate market from general acute care hospitals. The researchers examined this effect in the context of routine pediatric procedures offered by both specialty children's hospitals and general acute care hospitals. The study found substantial empirical evidence of a differentiation effect in which competitive forces from non-children's hospitals appear largely irrelevant for specialty children's hospitals.
AHRQ-funded; HS024712.
Citation: McCarthy IM, Raval MV .
Price spillovers and specialization in health care: the case of children's hospitals.
Health Econ 2023 Oct; 32(10):2408-23. doi: 10.1002/hec.4734..
Keywords: Children/Adolescents, Hospitals, Healthcare Delivery
Feldman AG, Beaty BL, Ferrolino Ja
Safety and immunogenicity of live viral vaccines in a multicenter cohort of pediatric transplant recipients.
This study’s objective was to determine the safety and immunogenicity of live vaccines in pediatric liver and kidney transplant recipients. This cohort study included 281 children, of which 270 had received a liver transplant, 9 a kidney transplant, and 2 were liver-kidney transplant recipients. None of the children included had completed their primary measles-mumps-rubella (MMR) and varicella-zoster virus (VZV) vaccine series and/or had displayed nonprotective serum antibody levels at enrollment between January 1, 2002, and February 28, 2023. Safety data was collected after these transplant recipients had received 1 to 3 doses or MMR vaccine and/or 1 to 3 doses of VZV vaccine. The median time from transplant to enrollment was 6.3 years, with the median age at first posttransplant vaccine 8.9 years. The majority of children developed protective antibodies following vaccination (107 of 149 varicella, 130 of 152 measles, 100 of 120 mumps, and 124 of 125 rubella). One year post vaccination, the majority of children who initially mounted protective antibodies maintained this protection (34 of 44 varicella, 45 of 49 measles, 35 of 42 mumps, 51 of 54 rubella). Five children developed varicella, all of which resolved within 1 week, and there were no cases of measles or rubella and no episodes or graft rejection within 1 month of vaccination. There was also no association between antibody response and immunosuppression level at the time of vaccination.
AHRQ-funded; HS026510.
Citation: Feldman AG, Beaty BL, Ferrolino Ja .
Safety and immunogenicity of live viral vaccines in a multicenter cohort of pediatric transplant recipients.
JAMA Netw Open 2023 Oct; 6(10):e2337602. doi: 10.1001/jamanetworkopen.2023.37602..
Keywords: Children/Adolescents, Vaccination, Transplantation
Pantell MS, Holmgren AJ, Leary JC
Social and medical care integration practices among children's hospitals.
This study sought to describe screening practices for adverse social determinants of health (SDOH) among a national sample of children’s hospitals. The authors analyzed responses to the 2020 American Hospital Association Annual Survey. Among children's hospitals, they calculated the prevalence of screening for social needs, strategies to address social risks/needs, partnerships with community-based organizations to address social risks/needs at the individual and community level, and rates of impact assessments of how social risk-related interventions affect outcomes. They also used χ2 tests to compare results by hospital characteristics and weighted results to adjust for nonresponse. Out of 82 children’s hospitals in the sample, a total of 79.6% screened for and 96.0% had strategies to address at least 1 social risk factor, although rates varied by SDOH domain. These hospitals more commonly partnered with community-based organizations to address patient-level social risks than participated in community-level initiatives. SDOH intervention effectiveness was assessed in a total of 39.2% of hospitals. The authors found differences in social risk-related care practices commonly varied by hospital ownership and Medicaid population but not by region.
AHRQ-funded; HS028473.
Citation: Pantell MS, Holmgren AJ, Leary JC .
Social and medical care integration practices among children's hospitals.
Hosp Pediatr 2023 Oct; 13(10):886-94. doi: 10.1542/hpeds.2023-007246..
Keywords: Children/Adolescents, Hospitals, Social Determinants of Health
Soulsby WD, Lawson E, Okumura M
Socioeconomic factors are associated with severity of hospitalization in pediatric lupus: an analysis of the 2016 Kids' Inpatient Database.
This study’s goal was to investigate the relationship of income level and other socioeconomic factors with length of stay (LOS) in the hospital and severe lupus features using the 2016 Kids' Inpatient Database (KID). The cohort included children aged 2-20 identified with lupus hospitalization in the 2016 KID using International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) codes (M32). A total of 3,367 unweighted lupus hospitalizations were identified. Income level was found to be a statistically significant predictor of increased LOS in the hospital for those in the lowest income quartile. Black race, "other" race, and public insurance were also associated with severe lupus features.
AHRQ-funded; HS026383.
Citation: Soulsby WD, Lawson E, Okumura M .
Socioeconomic factors are associated with severity of hospitalization in pediatric lupus: an analysis of the 2016 Kids' Inpatient Database.
Arthritis Care Res 2023 Oct; 75(10):2073-81. doi: 10.1002/acr.25121..
Keywords: Healthcare Cost and Utilization Project (HCUP), Children/Adolescents, Hospitalization, Chronic Conditions