Using Appendicitis to Improve Estimates of Childhood Medicaid Participation Rates.

Objective: Administrative data are often used to estimate state Medicaid/Children's Health Insurance Program duration of enrollment and insurance continuity, but they are generally not used to estimate participation (the fraction of eligible children enrolled) because administrative data do not include reasons for disenrollment and cannot observe eligible never-enrolled children, causing estimates of eligible unenrolled to be inaccurate. Analysts are therefore forced to either utilize survey information that is not generally linkable to administrative claims or rely on duration and continuity measures derived from administrative data and forgo estimating claims-based participation. We introduce appendectomy-based participation (ABP) to estimate statewide participation rates using claims by taking advantage of a natural experiment around statewide appendicitis admissions to improve the accuracy of participation rate estimates.

Auditing Practice Style Variation in Pediatric Inpatient Asthma Care.

Importance: Asthma is the most prevalent chronic illness among children, remaining a leading cause of pediatric hospitalizations and representing a major financial burden to many health care systems.

Objective: To implement a new auditing process examining whether differences in hospital practice style may be associated with potential resource savings or inefficiencies in treating pediatric asthma admissions.

Design, Setting, And Participants: A retrospective matched-cohort design study, matched for asthma severity, compared practice patterns for patients admitted to Children's Hospital Association hospitals contributing data to the Pediatric Hospital Information System (PHIS) database.

Medicaid and CHIP retention among children in 12 states.

Objective: Though stable insurance is important to support optimal child health, the reproducibility of metrics to assess child health insurance retention at the state and county level has not been examined. We sought to determine reproducibility of public insurance retention rates for children using 3 different metrics at the state and county level.

Methods: Public health insurance retention for children was assessed using 3 different metrics calculated from 2006-2009 Medicaid Analytic Extract data from 12 selected states.

Challenges to measuring variation in readmission rates of neonatal intensive care patients.

Objective: To examine the viability of a hospital readmission quality metric for infants requiring neonatal intensive care.

Methods: Two cohorts were constructed. First, a cohort was constructed from infants born in California from 1995 to 2009 at 23 to 34 weeks' gestation, using birth certificates linked to maternal and infant inpatient records (N = 343,625).