The majority of injuries and deaths in children and adolescents are preventable. Although the importance of preventive services has been identified, there still are barriers, flaws, and disparities in the content and delivery of clinical preventive services.
Intervention to improve delivery of adolescent preventive health services.
Description:
Researchers are analyzing the value of a QI strategy to enhance delivery of office-based clinical preventive services for adolescents during routine well-care visits.
Principal Investigator: Charles E. Irwin (AHRQ grant HS11095).
Will enhanced services alter future parental practices?
Description:
Investigators will assess whether enhanced delivery of behavioral and developmental services in children's first 3 years of life changes parental attitudes and practices when their children reach 5 years of age.
Principal Investigator: Cynthia Minkovitz (AHRQ grant HS13086).
QI systems improve service delivery.
Description:
Researchers had project teams work with QI teams in eight primary care practices to develop systems to assess and improve the delivery of immunizations and screening (for anemia, tuberculosis, and lead exposure). The proportion of children with complete immunizations improved 7 percent within 1 year and 12 percent after 2 years.
Citation: Bordley, Margolis, Stuart, et al. Pediatrics Electronic Pages 108(3):E41, http://www.pediatrics.org, 2001 (AHRQ grant HS08509).
Long-term benefits of routine newborn hearing screening are unclear.
Description:
Evidence suggests that universal screening leads to earlier identification and treatment of infants with hearing loss. However, the evidence is inconclusive about whether earlier treatment as a result of screening leads to long-term improvements in language skills.
Citation: Thompson, McPhillips, Davis, et al. JAMA 286(16):2000-10, 2001 (AHRQ contract 290-97-0018).
Study finds lower than expected risk of intussusception.
Description:
The claim that the rotavirus vaccine Rotashield increases risk of intussusception by approximately 20-fold were not confirmed, say researchers. Based on an analysis of hospital discharge data from 10 States, no increase in hospital infant admission rates for intussusception followed vaccination with Rotashield (Intramural).
Citation: Simonsen, Morens, Elixhauser, et al. Lancet 358:1224-9, 2001 (AHRQ Publication No. 02-R016)
Available from: AHRQ Publications Clearinghouse.
Survey uncovers discrepancies in immunization practices.
Description:
Researchers conducted a national survey of 252 pediatric nurse practitioners. Although 44 percent were less likely to vaccinate a child during an acute care visit, 56 percent treated this situation the same as a routine, well-child visit.
Citation: Richard K. Zimmerman (AHRQ grant HS09527), Immunization Barriers: A Study of Pediatric Nurse Practitioners (Final Report, NTIS Accession No. PB2002-100268).
Available from: The National Technical Information Service.
Availability of free vaccines affects clinicians' referrals.
Description:
Researchers surveyed primary care pediatric nurse practitioners (PNPs) about their use of free vaccines provided by the Federal Vaccines for Children Program. PNPs who received free vaccine supplies were less likely than those who did not to refer children to public clinics for vaccinations.
Citation: Zimmerman, VanCleve, Medsger, et al. Matern Child Health J 4(1):53-8, 2000 (AHRQ grant HS09527).
Medicaid managed care enrollment improves use of well-child care.
Description:
Researchers examined the impact of mandatory Medicaid managed care enrollment on access to and use of health care services by 488 mother-infant pairs and found that managed care enrollment had a positive effect on use of well-child care when compared with private insurance and lack of insurance.
Citation: Laurel K. Leslie (AHRQ grant HS09563), Medicaid Changes: Impact on at-Risk Children (Final Report, NTIS Accession No. PB2000-105025).
Available from: The National Technical Information Service.
Economic barriers prevent timely immunizations.
Description:
According to this study, children are vaccinated later in the practices of providers who do not receive free vaccine supplies, those that refer uninsured children to a public vaccine clinic, and providers who over-interpret contraindications to vaccinations.
Citation: Zimmerman, Mieczkowski, and Michel. Fam Med 31(5):317-23, 1999 (AHRQ grant HS08068).
A majority of clinicians consider early childhood hepatitis B vaccination to be important.
Description:
In a 1995 telephone survey, 78 percent of 1,236 primary care physicians rated vaccination against the hepatitis B virus as important, 7 percent rated it as unimportant, and 15 percent gave it an intermediate rating.
Citation: Zimmerman and Mieczkowski. J Fam Pract 47(5):370-74, 1998 (AHRQ grant HS08068).
Demographics, rather than geographics, account for disparities in immunization rates.
Description:
Analysis of the 1991 National Maternal and Infant Health Survey and the 1993 National Health Interview Survey revealed no significant differences in immunization rates of rural and urban 2-year-old children. Low family income and education, minority race, parental unemployment, and female sex were associated with underimmunization.
Citation: Lowery, Belansky, Siegel, et al. J Fam Pract 47(3):221-5, 1998 (AHRQ contract 290-93-0039).
Reasons for low immunization rates include referral practices and cost.
Description:
A survey of 1,236 physicians found that uninsured children are not as likely as insured children to be immunized when they see their primary care physicians, particularly when the doctor does not receive free vaccines.
Citation: Zimmerman, Medsger, Ricci, et al. JAMA 278(12):996-1000, 1997 (AHRQ contract HS08068).
Feedback and financial incentives do not improve pediatric preventive care.
Description:
In this study, providing pediatricians in Medicaid managed care organizations with feedback on compliance with preventive health services and financial bonuses did not increase their provision of these services.
Citation: Hillman, Ripley, Goldfarb, et al. Pediatrics 104(5):931-5, 1999 (AHRQ grant HS07634).
Providers often do not address major injury-prevention issues during well-child visits.
Description:
A survey of 465 pediatricians, family physicians, and pediatric nurse practitioners found that attitudes about certain childhood injuries, rather than knowledge about the prevalence of particular injuries, affected which counseling topics the clinicians discussed with their patients.
Citation: Barkin, Fink, and Gelberg. Arch Pediatr Adolesc Med 153:1226-31, 1999 (NRSA training grant T32 HS00046).
Clinicians often do not counsel parents on drowning prevention.
Description:
Despite the high incidence of drowning injuries in Los Angeles County, only one-third of a random sample of primary care providers counseled parents about drowning prevention. Two-thirds of the PCPs surveyed did not know that deaths of young children due to drowning are more common than deaths due to poisoning and firearm injury.
Citation: Barkin and Gelberg. Pediatrics 104(5):1217-19, 1999 (NRSA training grant T32 HS00046).
In order to assess quality of care and patient safety, researchers are developing quality measures, analyzing medical injuries, and assessing the usefulness of guidelines and other strategies to improve care.
Investigation focuses on choosing managed care plans for children with special needs.
Description:
This study will examine the factors used in selecting managed care plans by the parents of children with special health care needs, the difficulties they face in obtaining access to care, and indicators of quality of care.
Principal Investigator: Jean Mitchell (AHRQ grant HS10912).
Study focuses on the impact of electronic prescribing on patient safety.
Description:
After determining an institution's baseline medication error rate, investigators will compare handheld implements for electronic prescription writing and determine the effect of the instruments on error rates and prescribing practices.
Principal Investigator: Kevin B. Johnson (AHRQ grant HS11868).
Two centers for pediatric patient safety are being established.
Description:
One project will establish a Developmental Center for Evaluation and Research in Patient Safety (DCERPS) at the University of Washington Children's Hospital Regional Medical Center. The goal is to reduce and prevent medical errors. The second project involves collaboration between the University of Vermont, Harvard University, and Dartmouth University to establish a DCERPS in neonatal intensive care. Center programs will work to reduce medical errors, enhance patient safety, and determine how to learn most effectively from errors and communicate the information to families.
Principal Investigators: James A. Taylor (AHRQ grant HS11590) and Jeffrey D. Horbar (AHRQ grant HS11583).
Study examines effects of intensive care unit (ICU) errors.
Description:
The goal is to calculate the increase in resource use attributable to medication errors in the pediatric ICU, determine the risk of death from errors, and determine the risk of requiring inpatient rehabilitation or technology dependence associated with exposure to medication errors.
Principal Investigator: Joel D. Portnoy (AHRQ grant HS11636).
Researchers are validating quality-of-care measures for vulnerable children.
Description:
In the context of a school health initiative, this project will validate a health-related quality-of-life instrument and examine the relationships among structures and processes of care, health-related quality of life, and outcomes. The project will include children and families who speak English, Spanish, Tagalog, and Vietnamese.
Principal Investigator: Michael Seid (AHRQ grant HS10317).
Injury analysis will assess management of suspected abuse.
Description:
This study will analyze practitioner management of 16,000 childhood injuries and provide the first comprehensive analysis of the management of suspected child abuse in primary care practices.
Principal Investigator: Emalee G. Flaherty (AHRQ grant HS10746).
Effects of teamwork on errors in neonatal intensive care units.
Description:
Researchers are testing the hypothesis that specific behaviors in teamwork correlate with errors in delivering care to preterm infants during initial resuscitation and in the first 90 minutes of care.
Principal Investigator: Eric J. Thomas (AHRQ grant HS11164).
AHRQ's evidence-based practice program is synthesizing scientific evidence to improve quality of care.
Description:
Under this program, 12 5-year contracts have been awarded to institutions in the United States and Canada to serve as Evidence-based Practice Centers (EPCs). They review the scientific literature on assigned topics and produce evidence reports and assessments that can be used by public and private organizations as the basis for QI tools and activities. The following topics for evidence reports relevant to children were assigned in 2001 and are in development:
Regionalization of cardiac surgery patients saves lives.
Description:
A simulated regionalization of surgery study uncovered benefits to referring pediatric cardiac surgery patients from low- to high-volume hospitals. Based on 2 years of discharge data, results show a decrease in mortality along with an increase in travel distance for families.
Citation: Chang and Klitzner. Pediatrics 109(2):173-81, 2002 (NRSA training grant T32 HS00028).
CAHPS® survey results differ for adults and children.
Description:
Researchers examined the adult and child versions of the Consumer Assessment of Health Plans Study (CAHPS®). CAHPS® scores for children were significantly higher than those for adults except for customer service (which was lower for children) and specialist ratings (Intramural).
Citation: Zhan, Sangl, and Meyer. Med Care 40(2):145-54, 2002 (AHRQ Publication No. 02-R047)
Available from: AHRQ Publications Clearinghouse.
Factors affecting physician behavior change are outlined.
Description:
According to a review of studies on changing physician behavior to improve the quality of pediatric care, factors affecting change include: continuing medical education that includes interactive intervention, practice guideline implementation, reminders, and educational outreach (Intramural).
Citation: Bauchner, Simpson, and Chessare. Arch Dis Child 84:459-62, 2001 (AHRQ Publication No. 01-R067)
Available from: AHRQ Publications Clearinghouse.
Availability of care reduces ambulatory-care-sensitive hospitalizations.
Description:
Using Healthcare Cost and Utilization Project data, researchers analyzed 1994 hospital discharges. They found high rates of locally available primary care doctors and high market penetration by health maintenance organizations are associated with reduced hospitalizations for children with ambulatory-care-sensitive conditions (Intramural).
Citation: Friedman and Basu. J Managed Care 7(5):473-81, 2001 (AHRQ Publication No. 01-R074)
Available from: AHRQ Publications Clearinghouse.
A video and brochure are not sufficient to teach parents about the correct use of antibiotics.
Description:
A control group of parents (no intervention) was paired with an educational group who were shown a 20-minute video and given brochures on the appropriate use of antibiotics. After 2 months, only a modest effect on parent knowledge, beliefs, and self-reported behaviors was found in the intervention group.
Citation: Bauchner, Osganian, Smith, et al. Pediatrics 108(4):845-50, 2001 (NRSA training grant T32 HS00063).
Parental assessments note racial/ethnic disparities in care.
Description:
Parental evaluations of the pediatric care provided by 33 Medicaid HMOs in six States indicate the following: health plans need to pay increased attention to racial/ethnic differences in assessments of care, and language barriers are a significant contributor to racial/ethnic disparities in care.
Citation: Weech-Maldonado, Morales, Spritzer, et al. Health Serv Res 36(3):575-94, 2001 (AHRQ grant HS09204).
Proposed information technologies may empower families.
Description:
At the conference “Information Technology in Children's Health Care,” researchers described a variety of information technologies to assess their promise for improving care for children and barriers to their use. Technologies that can facilitate information sharing and empower children and families include the electronic pediatric personal medical record, customized health information systems, and interactive physician offices with E-mail and telemedicine capabilities.
Citations: Several papers commissioned for the conference were published: D'Alessandro and Dosa. Arch Pediatr Adolesc Med 155:1131-6, 2001; Kaushal, Barker, and Bates. Arch Pediatr Adolesc Med 155:1002-7, 2001; Weitzman and Shiffman. Arch Pediatr Adolesc Med 155:990-1, 2001; Johnson. Arch Pediatr Adolesc Med 155:1374-79, 2001 (AHRQ contract 290-95-2000).
Summit suggests improvements are needed in pediatric sedation practices.
Description:
The proceedings from a summit on pediatric sedation features lectures on the challenges facing providers of pediatric sedation and a roundtable discussion of controversial issues.
Citation: Joseph P. Cravero (AHRQ grant HS10110), Dartmouth Symposium on Pediatric Sedation (Final Report, NTIS Accession No. PB2002-102263).
Available from: The National Technical Information Service.
Study measures parental perceptions of primary care.
Description:
The Parent's Perceptions of Primary Care (P3C) is a 23-item questionnaire that asks parents to evaluate the elements of primary care defined by the Institute of Medicine. Researchers found the P3C has good internal consistency, reliability, and validity and can be used by pediatricians, medical groups, and policymakers.
Citation: Seid, Varni, Bermudez, et al. Pediatrics 108(2):264-70, 2001 (AHRQ grant HS10317).
Medication errors are common among hospitalized children.
Description:
Researchers analyzed data on 1,120 pediatric patients admitted to two urban teaching hospitals in 1999. They found errors occurred in 5.7 percent of medication orders. Also, the rate of potential adverse drug events was three times the rate found in a similar study of hospitalized adults.
Citation: Kaushal, Bates, Landrigan, et al. JAMA 285(16):2114-20, 2001 (NRSA training grant T32 HS00063).
Different measures are needed to assess the quality of health care provided to children and adults.
Description:
Because children differ from adults in their health care needs and in the way they use care, researchers should use measures of health care quality that are appropriate to children. Future research should address specific methodologic challenges involved in measuring quality of pediatric health care (Intramural).
Citation: Palmer and Miller. Ambulatory Pediatrics 1(1):39-52, 2001 (AHRQ Publication No. 01-R037)
Available from: AHRQ Publications Clearinghouse.
Parents stress the importance of parent-doctor and child-doctor communication.
Description:
The Child Core Survey from the Consumer Assessment of Health Plans Study (CAHPS®) was used to assess the interpersonal care of children based on parental responses. The most important factors—according to 3,083 assessments of overall care and of personal doctors—are parent-doctor communication, child-doctor communication, and sufficient time spent with the child.
Citation: Homer, Fowler, Gallagher, et al. Jt Comm J Qual Improv 25(7):369-77, 1999 (AHRQ grant HS09205).
Children in staff-model Medicaid managed care receive care equal to that of privately insured children in managed care.
Description:
Researchers used administrative data and a telephone survey to obtain data on access to, satisfaction with, and use of services for enrollees of Kaiser Permanente of Northern California. They found that Medicaid-enrolled children received care at least equal to that of their commercially enrolled peers (Intramural).
Citation: Newacheck, Lieu, Kalkbrenner, et al. Ambulatory Pediatrics 1(1):28-35, 2001 (AHRQ Publication No. 01-R039)
Available from: AHRQ Publications Clearinghouse.
Researchers review research on QI and examine barriers to QI activities in children's health care.
Description:
Researchers reviewed the published literature (1985-97) on QI activities in child health and interviewed experts. Research shows that some QI strategies are effective. Barriers to pediatric QI were similar to those for adult populations and were complicated by limited resources and difficulties in measuring health outcomes, among other factors (Intramural).
Citation: Ferris, Dougherty, Blumenthal et al. Pediatrics 107:143-55, 2001 (AHRQ Publication No. 01-R020)
Available from: AHRQ Publications Clearinghouse.
Measuring quality for vulnerable children requires a special approach.
Description:
These authors point out that pediatric quality measurement is distinct from that for adults because of factors related to children's development and dependence, differential epidemiology, demographic factors, and differences between the child and adult health service systems. A noncategorical approach, rather than one based on illness status or specific condition, is indicated.
Citation: Seid, Varni, and Kurtin. Am J Med Qual 15(4):182-8, 2000 (AHRQ grant HS10317).
Reducing errors in treating febrile infants may require system changes.
Description:
A research team found that 7 percent of infants arriving at the emergency room with a high fever were treated inappropriately. They either were given antibiotics they did not need or did not receive antibiotics they actually did need.
Citation: Glauber, Goldmann, Homer, et al. Pediatrics 105(6):1330-32, 2000 (NRSA grant T32 HS00063).
Embedding guidelines in a computer charting system does not improve quality of care.
Description:
Researchers embedded clinical guidelines for managing young children with high fevers and examined the impact of this approach on 830 febrile children under age 3. There were no changes in appropriateness of care or hospital charges for these children.
Citation: Schriger, Baraff, Buller, et al. J Am Med Inform Assoc 7(2):186-95, 2000 (AHRQ grant HS06284).
Study tracks hospital admissions data to determine impact of insurance status on potentially unnecessary hospitalizations.
Description:
Researchers used hospital data for 19 States to determine baseline rates of ambulatory-care-sensitive (ACS) conditions and analyze trends in the rates prior to the implementation of the State Children's Health Insurance Program. The rate of ACS admissions for self-pay and Medicaid-enrolled children increased between 1990 and 1995, but the rate for other insured children decreased significantly (Intramural).
Citation: Friedman, Jee, Steiner, and Bierman. Med Care Res Rev 56(4):440-55, 1999 (AHRQ Publication No. 00-R009)
Available from: AHRQ Publications Clearinghouse.
Monthly recertification of Medicaid eligibility may undermine health care quality.
Description:
Twelve months of continuous Medicaid enrollment and an assigned primary care physician (PCP) improved the care of children with middle ear infections, say researchers. Children who are continuously enrolled are far less likely to visit the ER for middle ear infections, more apt to receive antibiotics for the condition, and more likely to be referred for ear surgery than those who are discontinuously enrolled (due to monthly recertification) and lack a PCP.
Citation: Berman, Bondy, Lezotte, et al. Pediatrics 104(5):1192-7, 1999 (AHRQ grant HS07816).
A number of variables affect assessments of managed care for children.
Description:
A review of the research found that access to, satisfaction with, and quality of managed care depend on a range of variables. Future research should focus on specific features of managed care, managed care providers, and poor and chronically ill children (Intramural).
Citation: Simpson and Fraser. Med Care Res Rev 56(Suppl. 2), 13-36, 1999 (AHRQ Publication No. 99-R062)
Available from: AHRQ Publications Clearinghouse.
Pediatric practice guidelines lack input from families.
Description:
A review of the literature on pediatric practice guidelines found that patient and family involvement in guideline development has been limited, potentially affecting the likelihood that guidelines will be successfully implemented (Intramural).
Citation: Bauchner and Simpson. Health Serv Res 33(4):1161-77, 1998 (AHRQ Publication No. 99-R003)
Available from: AHRQ Publications Clearinghouse.
Do practice guidelines make a difference?
Description:
Researchers argue that practice guidelines can enhance health care quality. Physician participation in guideline development and their perception of the philosophy behind a guideline were identified as key factors affecting guideline acceptance (Intramural).
Citation: Simpson, Kamerow, and Fraser. Pediatr Ann 27(4):234-40, 1998. (AHRQ Publication No. 98-R081)
Available from: AHRQ Publications Clearinghouse.
Earlier recognition of a child's terminal illness allows clinicians and parents to focus on improving the child's quality of life and comfort.
Description:
According to researchers, doctors usually accept that a child is terminally ill about 6 months before the child's death, compared with 3 months for the parents. Earlier recognition of this prognosis by both doctors and parents was associated with more comfort treatment and greater integration of palliative care.
Citation: Wolfe, Klar, Grier, et al. JAMA 284(19):2469-75, 2001 (NRSA training grant T32 HS00063).
Caregivers should pay more attention to palliative care.
Description:
A review of medical records of children who had died of cancer showed that parents were more likely than physicians to report that their child had fatigue, poor appetite, constipation, and diarrhea and that these symptoms were not recognized by the medical team. Also, pain was more likely in children whose parents reported that the physician was not actively involved in end-of-life care.
Citation: Wolfe, Grier, Klar, et al. N Engl J Med 342:326-33, 2000 (NRSA training grant T32 HS00063).
Providers give reasons for not reporting all cases of suspected child abuse.
Description:
Researchers surveyed 85 providers in a regional practice-based research network. Reasons given for not reporting suspected abuse included uncertainty about the abuse diagnosis, past negative experience with Child Protective Services, and a perception that past reporting of abuse did not help the child.
Citation: Flaherty, Sege, Binns, et al. Arch Pediatr Adolesc Med 154:489-93, 2000 (AHRQ grant HS09811).
High-quality research in children's health care can only come from having a pool of talented researchers and a strong infrastructure to support analytic projects. AHRQ is committed to the development and support of health services researchers, particularly minority researchers and those who are new to the field.
Conference focused on ways to improve child health care.
Description:
The purpose of the March 2002 First Annual Forum for Improving Children's Health Care was to disseminate best practices and research findings. Tracks focused on improving care and flow in clinical settings, teaching and education, safety and therapy, and systems of care.
Principal Investigator: Charles Homer (AHRQ grant HS12070).
Child health services researchers (CHSRs) meet.
Description:
The fourth annual CHSR meeting featured plenary sessions on the future of CHSR and community-focused CHSR. Sessions addressed health insurance, welfare reform, patient safety, disparities, mental health treatment, and issues pertaining to terrorism. Go to http://academyhealth.org/childhealth/agenda.htm to access slides and presentations from the meeting. The fifth annual meeting will be held June 26, 2003 in Nashville, TN.
Principal Investigator: Wendy Valentine (AHRQ grant HS08201).
Scholars and data users discuss methodology and measures.
Description:
The Pediatric Health Status and Outcome Measurement Conference will address the current state of knowledge in pediatric measures, as well as measurement validity, appropriate ways to obtain data, and use of measures.
Principal Investigator: Lynn Olson (AHRQ grant HS12078).
Child health services research consortium is planned.
Description:
This project will develop the infrastructure to generate and support a child health services research program in the Intermountain West. The program will emphasize children with special health care needs.
Principal Investigator: Charles J. Hoff (AHRQ grant HS11826).
Program focuses on improving health in the Mississippi Delta.
Description:
Investigators will develop a multidisciplinary research program to improve the health care and health outcomes of underserved, rural, predominantly minority children in 12 impoverished counties in the Mississippi Delta.
Principal Investigator: Linda H. Southward (AHRQ grant HS11849).
Phase II of Pediatric Practice Research Group (PPRG) begins.
Description:
During this phase of an ongoing PPRG study, researchers will develop a plan for phased trials of computerized data collection in the practice setting, develop strategies for implementing studies that lead to enhanced patient care, and examine the challenges and diversity of clinic flow patterns.
Principal Investigator: Helen Binns (AHRQ grant HS11248).
Project will further develop a pediatric research group.
Description:
The Cincinnati Pediatric Research Group Enhancement Project will continue creating the infrastructure for an established community practice-based research network to provide pediatric primary care.
Principal Investigator: Michele Kiely (AHRQ grant HS11201).
Data collection methodologies will be compared.
Description:
This study will compare the traditional paper/pencil data collection for the National Ambulatory Medical Care Survey (NAMCS) with data collection via Web-based technologies.
Principal Investigator: Richard C. Wasserman (AHRQ grant HS11192).
Study to obtain measures to monitor access and quality.
Description:
This Mentored Clinical Scientist Development Award will enable the investigator to conduct research using interviews, focus groups, and a pilot test to document the factors necessary for monitoring access and quality of primary health care for homeless youths.
Principal Investigator: B. Josephine Ensign (AHRQ grant HS11414).
Four projects support and facilitate health services researchers' career development in children's health.
Description:
An Independent Scientist Award to Marielana Lara is facilitating her development as a researcher whose work will improve health outcomes and quality of life for Latino children with asthma (AHRQ grant K08 HS00008). John Feudtner's 5-year project will develop techniques to monitor health care use for indicators of quality of care for dying children and develop and test a longitudinal needs assessment program for children with complex chronic conditions (AHRQ grant K08 HS00002). Glenn Flores is focusing on ways to increase health coverage of Hispanic children. (AHRQ grant K02 HS11305). Christopher Forrest's project will focus on the mechanisms by which managed care influences children's access to medical care, use of specialty care, and expenditures for health care. He will examine the impact of alternative models of primary-specialty care collaboration on quality, costs, and outcomes for children with chronic and mental health disorders (AHRQ grant K02 HS00003).
Training program builds the field of child health services research.
Description:
This project supports and expands an ongoing training program for pediatric health services research within the Children's Hospital in Boston.
Principal Investigator: Donald Goldmann (NRSA grant T32 HS00063).
New KID database facilitates child health services research.
Description:
In August 2001, AHRQ unveiled the Kids' Inpatient Database (KID), the Nation's first all-children's hospital care research database. It was developed for use in making national and regional estimates of children's treatment, including surgery and other procedures, and for estimating treatment outcomes and hospital charges. The database includes information on the hospital care of children from birth through age 18, regardless of insurance status.
The KID contains information on the inpatient stays of about 1.9 million children at over 2,500 hospitals across the country in 1997. KID is a component of AHRQ's Healthcare Cost and Utilization Project (HCUP) (Intramural).
Methodological problems pose special challenges for research on pediatric health issues.
Description:
The authors outline methodological challenges in child health services research, including issues involving empirical research, policy analyses, evidence-based guidelines, and QI (Intramural).
Citation: Lohr, Dougherty, and Simpson. Ambulatory Pediatrics 1:36-8, 2001 (AHRQ Publication No. 01-R038)
Available from: AHRQ Publications Clearinghouse.
Proceedings highlight key issues in child health.
Description:
This report describes a 1998 conference, which provided a forum for introducing junior investigators to key issues in child health services research.
Citation: James Perrin (AHRQ grant HS09815), Ambulatory Pediatric Association Child Health Services Research Conference (final report, NTIS Accession No. PB2000-105025).
Available from: The National Technical Information Service.
Researchers examine the epidemiology and causes of injuries.
Description:
This project will examine the epidemiology and causes of pediatric injuries seen in emergency and outpatient departments.
Principal Investigator: Simon J. Hambidge (AHRQ/HRSA joint project 240-97-0043).
Researchers will analyze trends in managing splenic injury.
Description:
Study participants plan to characterize the diffusion of nonoperative management of splenic injury in children within a regionalized trauma system.
Principal Investigator: Daniela H. Davis (AHRQ/HRSA joint project 240-97-0043).
Office visits will include assessments of school readiness.
Description:
This project will analyze current practices during pediatric office visits. Investigators will focus on the school readiness assessment from the National Survey of Early Childhood Health.
Principal Investigator: Alice Kuo (AHRQ/HRSA joint project 240-97-0043).
Researchers are assessing poverty, diet, and poor growth in U.S. children.
Description:
This project is examining how poverty and growth are associated in U.S. children aged 2 months to 5 years.
Principal Investigator: Jennifer Kasper (AHRQ/HRSA joint project 240-97-0043).
Center will focus on therapeutics for the pediatric population.
Description:
Improvement in child health is the focus of this Center for Education and Research on Therapeutics. Potential study topics include therapeutic drug monitoring in HIV-infected children, drug metabolism, vitamin D-deficient rickets, asthma care, attention-deficit/hyperactivity disorder, and adverse drug reactions.
Principal Investigator: William Campbell (AHRQ grant HS10397).
Telemedicine may enhance pediatric care in rural, urban, and suburban settings.
Telemedicine employs telecommunications and computer technology as a substitute for in-person contact between providers and patients. Investigators are examining whether telemedicine will improve access and increase the efficiency of routine pediatric care in urban and suburban areas.
Principal Investigator: Kenneth McConnochie (AHRQ grant HS10753).
Children can provide valid answers to questions about their health.
Description:
Using three cross-sectional interviews of children, investigators determined the children's ability to respond to questions about their health. The results will enable the development of a pediatric health status questionnaire for children aged 6 to 11.
Citation: Rebok, Riley, Forrest, et al. Qual Life Res 10:59-70, 2001 (AHRQ grant HS07045).
Evidence syntheses in child health are difficult to build.
Description:
Child health researchers face a lack of high-quality primary studies, difficulty in finding existing studies, variability in the usefulness of outcome measures, and problems with production and dissemination.
Citation: Moyer. Ambulatory Pediatrics 1(1):53-58, 2001 (AHRQ grant HS09815).
AHRQ's provides information on the Agency's children's health services research agenda, including detailed information on funding opportunities. Also, the Child and Adolescent Health page includes a State-by-State map of AHRQ-funded research projects and other child health services research information.
Further details on AHRQ's programs and priorities in child health services research are available from:
Denise M. Dougherty, Ph.D.
Senior Advisor, Child Health
Agency for Healthcare Research and Quality
540 Gaither Road, Suite 2000
Rockville, MD 20850
Phone: (301) 427-1868
Fax: (301) 427-1561
E-mail: DDougher@ahrq.gov
AHRQ makes documents available free of charge through its Publications Clearinghouse. Other documents are available from the National Technical Information Service (NTIS). To order an AHRQ document, contact the source listed in the text using the information below and give the publication number.
Call 800-358-9295; from outside the United States, call (703) 437-2078; toll-free TDD services for the hearing impaired only 888-586-6340; or send a postcard to:
AHRQ Publications Clearinghouse
Attn: (include publication number as listed in Children's Health Highlights)
P.O. Box 8547
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Electronic requests may be made to: AHRQPubs@ahrq.hhs.gov.
To purchase documents, call or write NTIS and refer to the title of the publication and NTIS accession number as listed in Children's Health Highlights:
National Technical Information Service (NTIS)
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AHRQ Publication No. 03-P008
Current as of November 2002
Internet Citation:
Children's Health Highlights. November 2002. AHRQ Publication No. 03-P008. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/child/highlts/chhigh1.htm
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