A comprehensive difficult airway program was associated with a reduction in the number of emergency surgical airway procedures performed for the inability of an anesthesiologist to intubate and ventilate, a reduction that was sustained over an 11-yr period. This decrease occurred despite an increase in the number of patients reported to have a difficult airway and an overall increase in the total number of patients receiving anesthesia per year.

OBJECTIVES:To determine if longitudinal associations exist between parental incarceration (PI) and health care use or health behaviors among a national sample of young adults. METHODS:We used the National Longitudinal Survey of Adolescent to Adult Health to examine associations between history of mother incarceration (MI) and father incarceration (FI), health care use, and 3 dimensions of health behaviors (eg, general health behaviors, substance use, and other risky behaviors) (N = 13 084). Multivariable logistic regression models accounted for individual, family, and geographic factors and generated adjusted odds ratios (aORs). RESULTS:Over 10% of the sample had a history of PI before the age of 18. History of MI and FI were both associated with forgone health care (aOR = 1 CONCLUSIONS:The effects of incarceration extend beyond incarcerated individuals. PI histories are associated with lower health care use and unhealthy behaviors in young adulthood. By addressing barriers to health care and health-harming behaviors, health care providers and policy makers may reduce health disparities among this population. Dr Heard-Garris conceived and designed the study, acquired data, conducted data analysis and interpretation, and drafted the initial manuscript; Dr Winkelman conceived and designed the study, acquired data, conducted data analysis and interpretation, and provided critical revisions to the manuscript; Dr Choi assisted in data analysis and interpretation and provided critical revisions to the manuscript; Mr Miller conducted the literature review for the study and provided critical revisions to the manuscript; Dr Kan conceived and designed the study, acquired and interpreted data, and provided critical revisions to the manuscript; Dr Shlafer interpreted data and provided critical revisions to the manuscript; Dr Davis interpreted data, provided critical PEDIATRICS Volume 142, number 2, August 2018:e20174314 WHAT'S KNOWN ON THIS SUBJECT:A history of parental incarceration (PI) is associated with poor physical and mental health outcomes into adulthood. However, the relationship between PI and health care use and multidimensional health behaviors has been understudied. WHAT THIS STUDY ADDS:Young adults with PI histories are less likely to use health care and more likely to engage in unhealthy behaviors compared with peers without PI. PI has been identified as 1 of several adverse childhood experiences (ACEs), a group of traumatic or persistent childhood experiences associated with poor physical and mental health across the life course. 8 -11 PI is associated with learning delays and behavioral problems, 12 -15 perhaps because of the traumatic separation from a parent, the loss of parental resources, and the lack of social support. 7,12 The authors of a growing body of literature indicate that PI is detrimental to health in childhood and adulthood. The prevalence of asthma, HIV and AIDS, depression, anxiety, and posttraumatic stress disorder is higher among individuals with a history of PI. 16,17 In contrast to wha...

Objective In this brief report, we characterize pediatric primary care service utilization in metropolitan Chicago over the first 24 weeks of the COVID-19 pandemic response in relation to the comparable time period in 2019. Methods We examined retrospective visit and billing data, regardless of payer, from 16 independent pediatric practices that utilize a common electronic medical record platform within an Accountable Care Organization of 252 pediatricians in 71 offices throughout metropolitan Chicago. We categorized visits as Well-Child and Immunization-Only (WC-IO) or Other types and identified visits with a telemedicine billing modifier. Diagnoses for Other visits were tallied and categorized using the Agency for Healthcare Research and Quality Clinical Classification System. We summarized counts of visits and the proportion of visits with a telemedicine billing modifier in one-week epochs for 2020 compared with 2019. Results There were 102 942 total visits (72 030 WC-IO; 30 912 Other) in 2020 and 144 672 visits (80 578 WC-IO; 64 094 Other) in 2019. WC-IO visits in 2020 were half of 2019 visits at the start of the Illinois Stay-at-Home Order and returned greater than 90% of 2019 visits in 8 weeks. Other visit types have remained below 70% of 2019 visits. A telemedicine billing modifier peaked in mid-April (21% of all visits) and declined to <10% of all visits in June (Phase 2 reopening). The top 10 most common diagnoses differed between years. Conclusions Recovery of well child and immunization visits suggests that practice-level efforts and policy change can ensure children receive recommended care as the pandemic evolves.