Should healthcare organizations be accountable for child community health indicators at the community level?

Purpose Of Review: This paper reviews options for including community health accountability metrics for child healthcare systems, international and regional experience with such metrics, and some specific candidates for metric consideration.

Recent Findings: The inclusion of community metrics in child health accountability systems requires expanded accountability frameworks and re-education of clinicians. Most of the experience with use of community metrics in accountability systems comes from international settings.

Association of Exposure to Interpersonal Racism and Racial Disparities in Inadequate Sleep Risk.

Objective: To examine the association between caregiver-report of their child's inadequate sleep and exposure to interpersonal racism within racially minoritized subpopulations.

Study Design: We conducted cross-sectional analysis among racially minoritized 21 924 school-aged children and 27 142 adolescents using a National Survey of Children's Health sample from 2016 through 2021. Multivariable logistic regression models were fit to estimate predicted probabilities for the adjusted associations between caregiver-report of their child's inadequate sleep and prior exposure to interpersonal racism.

Postpartum Depression Screening in Pediatric Primary Care Clinics and Infant Receipt of Preventive or Acute Care.

Objective: To evaluate the association between postpartum depression (PPD) screening results in pediatric primary care and subsequent infant preventive and acute care utilization.

Methods: This was a retrospective cohort analysis of 5341 infants born in 2021 whose mothers were screened for PPD at a well-child visit during the first 6 months. Logistic regression was used to examine the association between a positive PPD screen and 1) adherence to the 12-month well-child visit, and 2) any acute care visits (urgent care or emergency department visits) from 6-15 months.

Rural-urban differences in social and emotional protective factors and their association with child health and flourishing.

Background: Children in rural communities experience higher mortality rates and less access to health care services than those in urban communities. Protective factors like social support also vary by geography, but their contribution to differences in child health is understudied. Understanding geographic variation in protective health factors could provide insight into their impact on health and guide future intervention strategies.

Healthcare Use Among Black and White Congenital Heart Disease Medicaid Enrollees.

Congenital heart disease (CHD) is the most common birth anomaly in the US. Research shows lost-to-follow-up trends and racial disparities in healthcare use. This study examines racial differences in healthcare use among Medicaid-covered children with CHD.

Assessment of US Federal Funding of Incarceration-Related Research, 1985 to 2022.

Importance: The US leads the world in the raw number of incarcerated persons as well as the rate of incarceration, with detrimental effects on individual-, family-, community-, and population-level health; as such, federal research has a critical role in documenting and addressing the health-related impacts of the US criminal legal system. How often incarceration-related research is funded at the National Institutes of Health (NIH), National Science Foundation (NSF), and US Department of Justice (DOJ) levels has a direct association with the public attention given to mass incarceration as well as the efficacy of strategies to mitigate negative effects and poor health related to incarceration.

Objective: To understand how many incarceration-related projects have been funded at the NIH, NSF, and DOJ.

Social Determinants of Health Needs and Pediatric Health Care Use.

Objective: To examine the associations between family-reported social needs in primary care settings and pediatric health care use.

Study Design: Data were obtained for a sample of 56 253 children and youths (age 0-21 years) who received primary care at a large hospital-based pediatric institution between June 2018 and October 2019 to estimate a propensity score for the probability of being seen in a primary care clinic. Inverse probability weighted regression specifications were used to examine the associations between reported social needs and health care use.

Smoking among adult congenital heart disease survivors in the United States: Prevalence and relationship with illness perceptions.

The relationship between smoking and illness perceptions among congenital heart disease (CHD) survivors is unknown. The primary aims of the present study were to compare the smoking prevalence among CHD survivors to a nationally representative U.S.

Left behind again: Rural home health services in a Medicaid pediatric accountable care organization.

Purpose: To contrast trends in rural and urban pediatric home health care use among Medicaid enrollees.

Methods: Medicaid administrative claims data were used to assess differences in home health care use for child members in a large pediatric accountable care organization (ACO) in Ohio. Descriptive statistics assessed rural and urban differences in health care use over a 10-year period between 2010 and 2019.

Trends in healthcare utilisation for firearm-related injuries among a cohort of publicly insured children in Ohio.

Objective: To examine healthcare utilisation for all firearm-related injuries among publicly insured children.

Methods: A retrospective analysis of firearm injury medical claims among paediatric (<21 years) Medicaid beneficiaries in Ohio from 2010 to 2018. Factors associated with unintentional and intentional firearm injury were explored using multivariable logistic regression.

Contribution of Social Determinant of Health Factors to Rural-Urban Preventive Care Differences Among Medicaid Enrollees.

Objective: 1) Assess whether rural-urban disparities are present in pediatric preventive health care utilization; and 2) use regression decomposition to measure the contribution of social determinants of health (SDH) to those disparities.

Methods: With an Ohio Medicaid population served by a pediatric Accountable Care Organization, Partners For Kids, between 2017 and 2019, we used regression decomposition (a nonlinear multivariate regression decomposition model) to analyze the contribution of patient, provider, and SDH factors to the rural-urban well-child visit gap among children in Ohio.

Results: Among the 453,519 eligible Medicaid enrollees, 61.

Patient Sharing and Health Care Utilization Among Young Adults With Congenital Heart Disease.

Transitions from pediatric to adult care by young adults with chronic conditions are fraught with challenges. Poor transitions lead to discontinuities of care that are avoidable with better communication between providers. We tested whether exposure to providers with sustained patient-sharing relationships resulted in fewer emergent admissions of young adults with congenital heart disease (CHD).

Coming full circle (to hard questions): Patient- and family-centered care in the hospital context.

Roughly 60 years after the first questions were raised about hospitalized patients, Kaslow and colleagues (see record 2020-40858-010) articulate the importance of patient- and family-centered care and outline recommendations for hospitalist care teams. They concisely point out the need for such practices, but more important, they provide many practical examples. Some of the main recommendations include (a) form partnerships, (b) prioritize communication, (c) discuss care goals, (d) share decision-making, (e) collaborate to implement the treatment plan, (f) negotiate differences, and (g) make special accommodations for discharge planning.

State Laws and Nonprofit Hospital Community Benefit Spending.

Objective: To determine the association of state laws on nonprofit hospital community benefit spending.

Design: We used multivariate models to estimate the association between different types of state-level community benefit laws and nonprofit hospital community benefit spending from tax filings.

Setting: All 50 US states.

Urban-Rural Differences in Service Utilization and Costs of Care for Racial-Ethnic Groups Hospitalized With Poststroke Aphasia.

Objective: Although residence is a key contributor to cost and utilization in stroke patient care, its contribution to the care of persons with aphasia (PWA) is unknown. The objective of this study was to use discharge-level hospital inpatient data to examine the influence of patient residence (rural vs urban) and race-ethnicity on service utilization and cost of care among PWA.

Design: Cross-sectional.

College students with congenital heart disease: A critical time for transition.

Unlabelled: As medical and surgical advances improve, more young adults with congenital heart disease (CHD) are attending college. This case study illustrates some of the issues that these young adults may face as they attend college and discusses the role that college health practitioners can play in easing that transition.

Participants: A case of a male with CHD presenting to the college health clinic with a new onset headache.

Understanding The Relationship Between Medicaid Expansions And Hospital Closures.

Decisions by states about whether to expand Medicaid under the Affordable Care Act (ACA) have implications for hospitals' financial health. We hypothesized that Medicaid expansion of eligibility for childless adults prevents hospital closures because increased Medicaid coverage for previously uninsured people reduces uncompensated care expenditures and strengthens hospitals' financial position. We tested this hypothesis using data for the period 2008-16 on hospital closures and financial performance.

Coordination Program Reduced Acute Care Use And Increased Primary Care Visits Among Frequent Emergency Care Users.

Many high utilizers of the emergency department (ED) have public insurance, especially through Medicaid. We evaluated how participation in Bridges to Care (B2C)-an ED-initiated, multidisciplinary, community-based program-affected subsequent ED use, hospital admissions, and primary care use among publicly insured or Medicaid-eligible high ED utilizers. During the six months after the B2C intervention was completed, participants had significantly fewer ED visits (a reduction of 27.

Greater healthcare utilization and costs among Black persons compared to White persons with aphasia in the North Carolina stroke belt.

Purpose: To examine racial differences in healthcare utilization and costs for persons with aphasia (PWA) being treated in acute care hospitals in North Carolina (NC).

Methods: NC Healthcare Cost and Utilization Project State Inpatient Database (HCUP-SID) data from 2011-2012 were analyzed to examine healthcare utilization and costs of care for stroke patients with aphasia. Analyses emphasized length of stay, charges and cost of general hospital services.

Ignition Interlock Laws: Effects on Fatal Motor Vehicle Crashes, 1982-2013.

Introduction: Alcohol-involved motor vehicle crashes are a major cause of preventable mortality in the U.S., leading to more than 10,000 fatalities in 2013.

Establishing a Baseline: Community Benefit Spending by Not-for-Profit Hospitals Prior to Implementation of the Affordable Care Act.

Context: Community Benefit spending by not-for-profit hospitals has served as a critical, formalized part of the nation's safety net for almost 50 years. This has occurred mostly through charity care. This article examines how not-for-profit hospitals spent Community Benefit dollars prior to full implementation of the Affordable Care Act (ACA).

National Trends in Emergency Department Visits by Adults With Mental Health Disorders.

Background: Although mental health disorders (MHDs) affect as many as 1 in 4 adults in the U.S., the national trends in emergency department (ED) use for adults who have MHD comorbidities are unknown.

Montana primary care providers' access to and satisfaction with pediatric specialists when caring for children with special health care needs.

Purpose: Primary care providers (PCPs) of children with special health care needs (CSHCN) in rural areas face challenges in accessing specialty care to support a patient-centered medical home. This study assessed the practice characteristics and attitudes regarding pediatric specialty care among Montana PCPs of CSHCN.

Methods: We surveyed 433 Montana PCPs identified through a statewide registry.