Publications by authors named "Jay Berry"

Article Synopsis
  • - The study analyzed over 63,000 surgical cases in children with complex chronic conditions to determine the prevalence and factors contributing to postoperative pneumonia (PoP) within 7 days of surgery, identifying significant variations across hospitals and surgical types.
  • - The overall prevalence of PoP was found to be 1.1%, with the highest rates occurring in bone marrow and solid organ transplants, while procedures like craniofacial surgeries had much lower rates.
  • - Children with four or more chronic conditions were at a notably higher risk for developing PoP, prompting the need for further research to reduce this risk, particularly for those with multiple health issues.
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Objectives: Although children with medical complexity (CMC) with high health resource utilization use outpatient structured clinical programs (SCP) to optimize their health, little is known about variation in trends of their health service use shortly after enrollment. We measured these trends and assessed the utility of patient characteristics to predict them.

Methods: Retrospective analysis of 506 CMC newly enrolled in an outpatient, academic SCP.

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Airway clearance therapies (ACT) are often used to optimize respiratory function for children with neurologic impairment (CNI) hospitalized with acute respiratory infections (ARI). In a five-center retrospective cohort study of CNI aged 1-18 years hospitalized between 2013 and 2015 with ARI, we assessed the association of admission ACT with hospital outcomes (days to return to baseline respiratory support and length of stay [LOS]). Generalized estimated equation (GEE) models examined the association between ACT and outcomes, while accounting for clustering.

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Article Synopsis
  • - The study aimed to assess and compare different statistical methods for identifying predictors of respiratory complications and infections in children with non-ambulatory cerebral palsy who underwent spine surgery, given their high risk for post-operative issues.
  • - A retrospective analysis was conducted using a large database, focusing on children aged 25 or younger with a diagnosis of cerebral palsy, examining their health records before and after surgery.
  • - Out of 220 children studied, around 21.8% experienced respiratory complications and 12.7% had infections within three months post-surgery; various factors such as age and sex were evaluated as potential predictors during the analysis.
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Article Synopsis
  • * Out of over 3.6 million hospital stays, 0.08% of discharges were AMA, with non-Hispanic Black patients being more likely to leave AMA, while Hispanic patients were less likely.
  • * Leaving AMA was linked to a higher chance of readmission within 14 days, indicating that this decision can pose significant risks to patient health.
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Background: Understanding the postoperative length of stay (LOS) by surgical procedure is important for hospital medicine clinicians involved in surgical co-management. We assessed variation in postoperative LOS for children after elective surgical procedures and risk factors for prolonged LOS.

Methods: This study is a retrospective analysis of pediatric patients undergoing elective surgical procedures between January 1, 2018 and October 1, 2021 with postoperative hospitalization for recovery at a freestanding children's hospital.

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Background And Objectives: Although skin and soft tissue infections (SSTIs) are among the most common indications for pediatric hospitalization, little is known about outpatient care received for SSTI before and after hospitalization. We assessed peri-hospitalization care for SSTI, including antibiotic exposures and their impact on hospital length of stay (LOS).

Methods: This is a retrospective cohort study of 1229 SSTI hospitalizations in 2019 from children aged 1-to-18 years enrolled in Medicaid from 10 US states included in the Merative Marketscan Medicaid database.

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Objectives: Examine family safety-reporting after implementing a parent-nurse-physician-leader coproduced, health literacy-informed, family safety-reporting intervention for hospitalized families of children with medical complexity.

Methods: We implemented an English and Spanish mobile family-safety-reporting tool, staff and family education, and process for sharing comments with unit leaders on a dedicated inpatient complex care service at a pediatric hospital. Families shared safety concerns via predischarge surveys (baseline and intervention) and mobile tool (intervention).

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Objective: The closure of inpatient pediatric units within general hospitals has contributed to the regionalization of pediatric care. For children in rural areas, the distance traveled for hospitalization impacts the quality of care for children, the families, and the preparedness for disaster planning within rural communities. We assessed trends in location of hospitalization over time for rural-residing children.

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Background And Objectives: Children with chronic neuromuscular conditions (CCNMC) have many coexisting conditions and often require musculoskeletal surgery for progressive neuromuscular scoliosis or hip dysplasia. Adequate perioperative optimization may decrease adverse perioperative outcomes. The purpose of this scoping review was to allow us to assess associations of perioperative health interventions (POHI) with perioperative outcomes in CCNMC.

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Aim: To identify and describe assessment tools used to measure the impact of comorbidities on postoperative outcomes in children with complex chronic conditions (CCC).

Method: This was a scoping review using five electronic databases. The search was conducted in March 2022 by a medical librarian.

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Background: The coronavirus disease 2019 (COVID-19) pandemic caused disruptions to pediatric surgical care. Although surgical capacity has returned to the prepandemic state, barriers to surgical access may still exist for children who are medically underserved. We assessed pediatric plastic and oral and maxillofacial surgical volumes by sociodemographic characteristics before and during the COVID-19 pandemic.

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Objectives: Racial and ethnic disparities in healthcare delivery for acutely ill children are pervasive in the United States; it is unknown whether differential critical care utilization exists.

Design: Retrospective study of the Pediatric Health Information System (PHIS) database.

Setting: Multicenter database of academic children's hospitals in the United States.

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It is important for hospitals to understand how hospitalizations for children are changing to adapt and best accommodate the future needs of all patient populations. This study aims to understand how hospitalizations for children with medical complexity (CMC) and non-CMC have changed over time at children's hospitals, and how hospitalizations for these children will look in the future. Children with 3+ complex chronic conditions (CCC) accounted for 7% of discharges and over one-quarter of days and one-third of costs during the study period (2012-2022).

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Background: Craniosynostosis is treated with endoscopic, open, and/or distraction surgical techniques. We assessed institutional variation in the use these techniques for craniosynostosis and compared hospital resource use.

Methods: Retrospective analysis of 5249 infants age <18 months old undergoing surgical procedures for all types of craniosynostosis in 2016-2020 in 39 freestanding children's hospitals in the Pediatric Health Information System (PHIS) database.

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Background: The American Society of Anesthesiologists Physical Status Classification System (ASA-PS) is used to classify patients' health before delivering an anesthetic. Assigning an ASA-PS Classification score to pediatric patients can be challenging due to the vast array of chronic conditions present in the pediatric population. The specific aims of this study were to (1) suggest an ASA-PS score for pediatric patients undergoing elective surgical procedures using machine-learning (ML) methods; and (2) assess the impact of presenting the suggested ASA-PS score to clinicians when making their final ASA-PS assignment.

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Importance: Although durable medical equipment and supplies (DMES) are commonly used to optimize the health and function in pediatric patients, little is known about the prevalence of use and spending on DMES.

Objective: To categorize the Healthcare Common Procedure Coding System (HCPCS) for distinguishing DMES types, and to measure the prevalence and related spending of DMES in pediatric patients using Medicaid.

Design, Setting, And Participants: This study is a cross-sectional analysis of the 2018 Merative Medicaid Database and included 4 569 473 pediatric patients aged 0 to 21 years enrolled in Medicaid in 12 US states from January 1 to December 31, 2018.

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Background And Objectives: High-flow nasal cannula (HFNC) therapy for hospitalized children with bronchiolitis is associated with a longer length of stay (LOS) when used outside of the ICU. We sought to explore the association between HFNC and LOS to identify if demographic and clinical factors may modify the effect of HFNC usage on LOS.

Methods: In this multicenter retrospective cohort study, we used a combination of hospital records and the Pediatric Health Information System.

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Objectives: Prior research suggests that errors occur frequently for patients with medical complexity during the hospital-to-home transition. Less is known about effective postdischarge communication strategies for this population. We aimed to assess rates of 30-day (1) postdischarge incidents and (2) readmissions and emergency department (ED) visits before and after implementing a hospital-to-home intervention.

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Objective: Pediatric researchers use Agency for Healthcare Research and Quality (AHRQ) Kids' Inpatient Database (KID) and National Inpatient Sample (NIS) to analyze the national resource use and outcomes of hospitalized children. Inherent KID-NIS sampling design differences may yield disparate findings. We compared discharge counts and length of stay (LOS) between KID and NIS for common and rare reasons for hospitalization.

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Objective: Surgical encounters decreased during the coronavirus disease (COVID-19) pandemic and may have been deferred more in children with impeded health care access related to social/community risk factors. We compared surgery trends before and during the pandemic by Child Opportunity Index (COI).

Methods: Retrospective analysis of 321,998 elective surgical encounters of children ages 0-to-18 years in 44 US children's hospitals from January 1, 2017 to December 31, 2021.

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