Health Insurance
Juvenile Incarceration and Health
Addressing the health status and needs of incarcerated youth represents an issue at the nexus of juvenile justice reform and health care reform. Incarcerated youth face disproportionately higher morbidity and higher mortality compared to the general adolescent population. Dental health, reproductive health, and mental health needs are particularly high, likely as a result of lower access to care, engagement in high-risk behaviors, and underlying health disparities. Violence exposure and injury also contribute to the health disparities seen in this population.The Stepped Wedge Cluster Randomized Trial and Its Potential for Child Health Services Research: A Narrative Review
We foresee an increasing role for the stepped wedge cluster randomized trial design in child health services research. Although a recent systematic review only identified 25 such studies,1 those studies offer themselves as compelling examples to consider. As we will demonstrate, the stepped wedge cluster randomized trial is particularly apt as a research design for health services research. Furthermore, the stepped wedge cluster randomized trial is particularly attractive for health services research concerning children and adolescents because its design addresses problems that complicate child health services research and differentiate those efforts from adult health services research.Children and the Patient Protection and Affordable Care Act: Opportunities and Challenges in an Evolving System
The Patient Protection and Affordable Care Act (ACA), passed in 2010, focused primarily on the problems of adults, but the changes in payment for and delivery of care it fosters will likely impact the health care of children. The evolving epidemiology of pediatric illness in the United States has resulted in a relatively small population of medically fragile children dispersed through the country and a large population of children with developmental and behavioral health issues who experience wide degrees of health disparities.Transition Care: Future Directions in Education, Health Policy, and Outcomes Research
All youth must transition from pediatric to adult-centered medical care. This process is especially difficult for youth with special health care needs. Many youth do not receive the age-appropriate medical care they need and are at risk during this vulnerable time. Previous research has identified barriers that may prevent effective transition, and protocols have been developed to improve the process. Health outcomes related to successful transition have yet to be fully defined. Health care transition can also be influenced by education of providers, but there are gaps in medical education at the undergraduate, graduate, and postgraduate levels.Measuring and Reporting Quality of Health Care for Children: CHIPRA and Beyond
The coming years could be a watershed period for children and health care as the nation implements the most significant federal health care legislation in 50 years: the Accountable Care Act (ACA). A year earlier, the American Recovery and Reinvestment Act (ARRA) set up a framework and road map for the eventual universal adoption of health information technology in its Health Information Technology for Economic and Clinical Health (HITECH) provisions, and the Children’s Health Insurance Program Reauthorization Act (CHIPRA) legislation articulated a new and compelling vision for quality measurement in child health services.Measures of Availability of Health Care Services for Children
The Children’s Health Insurance Program Reauthorization Act (CHIPRA) mandates that measures of availability of child health services be included in the recommended core measurement set. The objective of this work was to review and evaluate measures of availability of child health services for potential inclusion in the initial core set of health care quality measures as mandated by CHIPRA.A Measured Approach to Child Health
Children’s health and its measurement have gained increasing attention in the face of advances in treating disease, and the growing recognition of long-term implications of child health for adult health and the nation’s economy. Advances in measurement are aided by new conceptualizations, including a dynamic definition of child health and model of how it evolves. This paper discusses challenges in measurement of child health, the role of large-scale data sets, how to select a measure, 2 promising measurement frontiers, and the role of the Academic Pediatric Association in promoting a measured approach to child health.Impact of Managed Care on Publicly Insured Children with Special Health Care Needs
The aim of this review was to evaluate the impact of managed care on publicly insured children with special health care needs (CSHCN).Translational Research and Pediatrics
Translational research is a new buzzword in the health care research field, central to the National Institutes of Health's (NIH) Roadmap1,2 and promoted by academic institutions that have been awarded NIH Clinical and Translational Science Awards (CTSAs).3 Indeed, translational research is heralded by some as a savior of the biomedical research enterprise by hastening the translation of biomedical discoveries to improved patient care.4 Although pediatric translational research is a small part of the overall translational research enterprise, it is important for improving child health and provides new opportunities for researchers from all pediatric disciplines.
