Continuity of Care in Infancy and Early Childhood Health Outcomes

Enlow, Elizabeth; Passarella, Molly; Lorch, Scott A.

doi:10.1542/peds.2017-0339

Cited by 30 publications

(26 citation statements)

References 41 publications

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“…While a small number of studies have illustrated associations between continuity of care for well child visits and decreased risk of hospitalization for ACSC, further research is needed to determine if improved continuity of care for acute illnesses is associated with decreased risk of hospitalization and resource utilization during hospital stays. 23 , 24 In addition, our findings raise questions about whether expanding bundled payments for “episodes of care” to include healthcare during the pre-admission period would incentivize high value care across the care continuum. 25…”

Section: Discussionmentioning

confidence: 93%

Paediatric hospital admission processes and outcomes: a qualitative study of parents’ experiences and priorities

et al. 2018

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Section: Discussionmentioning

confidence: 93%

Paediatric hospital admission processes and outcomes: a qualitative study of parents’ experiences and priorities

et al. 2018

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“…As done in previous studies, we calculated two CoC outcomes per patient: (1) total, based on all visits and (2) well-care, based on well-child visits only. 5 We defined well-care visits as visits with a code or descriptor representing a well-care visit in at least one of the following structured EHR fields: Visit diagnosis code; Current Precedural Terminology (CPT) code; Visit type descriptor (see Supplementary 1). We also used the Visit type structured field to define same day sick visits as visits that had the descriptor “same day sick”.…”

Section: Methodsmentioning

confidence: 99%

Continuity of Care by Primary Care Provider in Young Children with Chronic Conditions

Bannett¹,

Lc³

et al. 2021

Preprint

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Objectives: (1) To assess continuity of care by primary-care provider (CoC), an established quality indicator, in children with asthma, autism spectrum disorder (ASD), and no chronic conditions, and (2) to determine patient factors that influenced CoC. Methods: Retrospective cohort study of electronic health records from all office visits of children under 9 years, seen >4 times between 2015 and 2019 in 10 practices of a community-based primary healthcare network in California. Three cohorts were constructed: (1)Asthma: >2 visits with asthma visit diagnoses; (2)ASD: same method; (3)Controls: no chronic conditions. CoC, using the Usual Provider of Care measure (range >0-1), was calculated for (1)total visits and (2)well care visits only. Fractional regression models examined CoC adjusting for patient age, medical insurance, practice affiliation, and number of visits. Results: Of 30,678 eligible children, 1875 (6.1%) were classified as Asthma, 294 (1.0%) as ASD, and 15,465 (50.4%) as Controls. Asthma and ASD had lower total CoC than Controls (Mean=0.58, SD 0.21, M=0.57, SD 0.20, M=0.66, SD 0.21). Differences among well CoC were smaller (Asthma M=0.80, ASD M=0.78, Controls M=0.82). In regression models, lower total CoC was found for Asthma (aOR 0.90, 95% CI 0.85-0.94). Lower total and well CoC were associated with public insurance (aOR 0.77, CI 0.74-0.81; aOR 0.64, CI 0.59-0.69). Conclusion: Children with asthma in this primary-care network had lower CoC compared to children without chronic conditions. Public insurance was the most prominent patient factor associated with low CoC. Quality initiatives should address disparities in CoC for children with chronic conditions.

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“…Reiterating these findings, families of children with microcephaly caused by the Zika virus report to feel fear and insecurity while performing stimulatory activities at home, since they are unsure whether they are doing these activities correctly and leading to positive results in the development of the child, in addition to having doubts as to the motor and intellectual evolution of the child (7) . Therefore, considering the principle of equity, according to which those who need the most should receive the most, these families must also receive assistance from the PHC team, which would allow them to receive continued and integral care, as well as to coordinate the access to the healthcare network (20) . As a consequence, we reiterate the need these families have for support, for shared monitoring from health teams at home and/or from the Family Health Support Center (NASF) team, so they can receive guidance and support for family stimulation.…”

Section: Because I'm Not a Professional That' S Why I' D Like Her Tomentioning

confidence: 99%

Stimulation of children with congenital Zika syndrome at home: challenges for the caregivers

Junqueira

Leôncio

Vaz

et al. 2020

Rev. Gaúcha Enferm.

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ABSTRACT Objective: To identify the challenges faced by caregivers regarding the stimulation of the development of children with congenital Zika syndrome at home. Method: A qualitative study was carried out with ten caregivers of children with the syndrome and five health professionals who work in a specialized service of reference for children/adolescents with disabilities in a city in Pernambuco, Brazil. Data collection took place between November 2018 and March 2019 through a semi-structured interview, and the data were interpreted using thematic analysis. Results: The challenges faced by caregivers are permeated by fear, insecurity and lack of support for the realization of the stimulatory activities at home. Practitioners acknowledge the situation but emphasize the importance of continuing the stimulatory activities to preserve the capabilities of these children. Conclusions: It is necessary to sensitize health teams to support families regarding the challenges faced and provide full time care for the child with Zika syndrome in order to achieve maximum development.

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Continuity of Care in Infancy and Early Childhood Health Outcomes

Abstract: Continuity may improve care quality and prevent high-cost health encounters, especially for children with chronic conditions. Novel solutions are needed to improve continuity in the medical home.

Cited by 30 publications

References 41 publications

Paediatric hospital admission processes and outcomes: a qualitative study of parents’ experiences and priorities

Paediatric hospital admission processes and outcomes: a qualitative study of parents’ experiences and priorities

Continuity of Care by Primary Care Provider in Young Children with Chronic Conditions

Stimulation of children with congenital Zika syndrome at home: challenges for the caregivers

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