Objective: To develop a set of pediatric acute care hospital referral regions for use in studying pediatric acute care delivery and test their utility relative to other regional systems.
Study Design: We used state-level administrative databases capturing all pediatric acute care in 8 states to construct novel referral regions. We first constructed pediatric hospital service areas (PHSAs) based on 5 837 464 pediatric emergency department encounters.
Objective: Geographic information systems (GIS) provide a unique set of tools to spatially analyze health care and identify patterns of health outcomes to help optimize delivery. Our goal is to create maps of pediatric tracheostomy patients using GIS to assess socioeconomic and other factors that impact postoperative care after discharge to home.
Methods: A retrospective study was performed on patients (≤21 years old) who underwent tracheostomy at a tertiary care pediatric hospital from January 1, 2015 to December 31, 2020.
Food insecurity (FI) is defined as "the limited or uncertain access to adequate food." One root cause of FI is living in a food desert. FI rates among people with cystic fibrosis (CF) are higher than the general United States (US) population.
View Article and Find Full Text PDFBackground: Long-term effects of sulfur dioxide (SO ) exposure on children, a vulnerable population, are largely unknown. Further, how long-term SO affects Puerto Rican children living in the island of Puerto Rico, a group with high asthma prevalence, is unclear. We evaluated the effects of annual average 1-hour daily maximum SO average on asthma, atopy, total immunoglobulin E (IgE), and lung function in Puerto Rican children.
View Article and Find Full Text PDFStudy Objective: Regional, coordinated care for time-sensitive and high-risk medical conditions is a priority in the United States. A necessary precursor to coordinated regional care is regions that are actionable from clinical and policy standpoints. The Dartmouth Atlas of Health Care, the major health care referral construct in the United States, uses regions that cross state and county boundaries, limiting fiscal or political ownership by key governmental stakeholders in positions to create incentive and regulate regional care coordination.
View Article and Find Full Text PDFPediatr Allergy Immunol Pulmonol
September 2016
Traffic-related air pollution (TRAP) may affect immune responses, including those in the T2 and T17 pathways. To examine whether TRAP is associated with plasma level of T17-, T1-, and T2-related cytokines in children with and without asthma, a cross-sectional study of 577 children (ages 6-14 years) with ( = 294) and without ( = 283) asthma in San Juan (Puerto Rico) was performed. Residential distance to a major road was estimated using geocoded home addresses for study participants.
View Article and Find Full Text PDFBackground: This study examines the epidemiologic data of pediatric craniofacial fractures secondary to violence, comparing these data to craniofacial fractures sustained from all other causes.
Methods: A retrospective review was completed on all patients who presented to the emergency department of a major urban children's hospital from 2000 to 2005 with a craniofacial fracture. Data were compared between patients with fractures due to violent and nonviolent mechanisms.
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