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  • American Academy of Pediatrics (AAP)  (2)
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  • American Academy of Pediatrics (AAP)  (2)
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  • 1
    Online Resource
    Online Resource
    Assessing the Quality Measure for Follow-up Care After Children’s Psychiatric Hospitalizations
    American Academy of Pediatrics (AAP) ; 2019
    In:  Hospital Pediatrics Vol. 9, No. 11 ( 2019-11-01), p. 834-843
    Details
    In: Hospital Pediatrics, American Academy of Pediatrics (AAP), Vol. 9, No. 11 ( 2019-11-01), p. 834-843
    Abstract: Medicaid and Children’s Health Insurance Program plans publicly report quality measures, including follow-up care after psychiatric hospitalization. We aimed to understand failure to meet this measure, including measurement definitions and enrollee characteristics, while investigating how follow-up affects subsequent psychiatric hospitalizations and emergency department (ED) visits. METHODS: Administrative data representing Alabama’s Children’s Health Insurance Program from 2013 to 2016 were used to identify qualifying psychiatric hospitalizations and follow-up care with a mental health provider within 7 to 30 days of discharge. Using relaxed measure definitions, follow-up care was extended to include visits at 45 to 60 days and visits to a primary care provider. Logit regressions estimated enrollee characteristics associated with follow-up care and, separately, the likelihood of subsequent psychiatric hospitalizations and/or ED visits within 30, 60, and 120 days. RESULTS: We observed 1072 psychiatric hospitalizations during the study period. Of these, 356 (33.2%) received follow-up within 7 days and 566 (52.8%) received it within 30 days. Relaxed measure definitions captured minimal additional follow-up visits. The likelihood of follow-up was lower for both 7 days (−18 percentage points; 95% confidence interval [CI] −26 to −10 percentage points) and 30 days (−26 percentage points; 95% CI −35 to −17 percentage points) regarding hospitalization stays of ≥8 days. Meeting the measure reduced the likelihood of subsequent psychiatric hospitalizations within 60 days by 3 percentage points (95% CI −6 to −1 percentage point). CONCLUSIONS: Among children, receipt of timely follow-up care after a psychiatric hospitalization is low and not sensitive to measurement definitions. Follow-up care may reduce the need for future psychiatric hospitalizations and/or ED visits.
    Type of Medium: Online Resource
    ISSN: 2154-1663 , 2154-1671
    URL: Article
    DOI: 10.1542/hpeds.2019-0137
    Language: English
    Publisher: American Academy of Pediatrics (AAP)
    Publication Date: 2019
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    Online Resource
  • 2
    Online Resource
    Online Resource
    Effectiveness of Preventive Dental Visits in Reducing Nonpreventive Dental Visits and Expenditures
    American Academy of Pediatrics (AAP) ; 2013
    In:  Pediatrics Vol. 131, No. 6 ( 2013-06-01), p. 1107-1113
    Details
    In: Pediatrics, American Academy of Pediatrics (AAP), Vol. 131, No. 6 ( 2013-06-01), p. 1107-1113
    Abstract: Although preventive dental visits are considered important for maintaining pediatric oral health, there is relatively little research showing that they reduce subsequent nonpreventive dental visits or costs. At least 1 study seemed to find that early preventive dental care is associated with more restorative and emergency visits. Previous studies are limited by their inability to account for unmeasurable factors that may lead children to “select” into using both more preventive and nonpreventive dental care. We used econometric techniques that minimize selection bias to assess the effectiveness of preventive dental care in reducing subsequent nonpreventive dental service utilization among children. METHODS: Using data from Alabama’s Children’s Health Insurance Program (CHIP), 1998–2010., a cohort study of children’s dental service utilization was conducted. Outcomes were 1-year lagged nonpreventive dental care and expenditures, and overall dental and medical expenditures. Children who were continuously enrolled for at least 3 years were included. Separate models were estimated for children aged & lt;8 years (n = 14 972) and those aged ≥8 years (n = 21 833). RESULTS: More preventive visits were associated with fewer subsequent nonpreventive dental visits and lower nonpreventive dental expenditures for both groups. However, more preventive visits did not reduce overall dental or medical (inclusive of dental) expenditures. CONCLUSIONS: Preventive dental visits can reduce subsequent nonpreventive visits and expenditures for children continuously enrolled in CHIP. However, they may not reduce overall program costs. Effective empirical research in this area must continue to address unobserved confounders and selection issues.
    Type of Medium: Online Resource
    ISSN: 0031-4005 , 1098-4275
    URL: Article
    DOI: 10.1542/peds.2012-2586
    Language: English
    Publisher: American Academy of Pediatrics (AAP)
    Publication Date: 2013
    detail.hit.zdb_id: 1477004-0
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