Issues in studying the effectiveness of health services for children.

Published on Oct 1, 1998in Health Services Research2.71
T A Lieu1
Estimated H-index: 1
Thomas B. Newman48
Estimated H-index: 48
Abstract OBJECTIVES: To discuss issues in studying the effectiveness of health services for children, suggest areas in which more research is needed, and recommend strategies for future research. PRINCIPAL FINDINGS: Issues that should be considered include the choice of perspective, which will help determine the interventions studied and the measures of effectiveness and cost-effectiveness chosen. Unique challenges in this area include the fact that serious measurable morbidity is relatively uncommon in children, that causal relationships between services and outcomes may be difficult to establish, and that standard measures of cost-effectiveness may fail to accurately measure important benefits, such as reduced parental anxiety. More research is needed on high-risk and health-promoting behaviors, on critical parent behaviors, on classifying children by vulnerability status, on modes of delivery of preventive care, and on violence prevention. RECOMMENDATIONS: Group-randomized designs and observational research designs that take advantage of natural variations in practice may be increasingly useful in effectiveness studies. Parent- and patient-reported measures of health status and quality of life should be made briefer and more practical for routine use, and better measures of cost-effectiveness are needed. Future research efforts can best be supported by the concerted efforts of various constituencies, including health plans, providers, patients, researchers, and the government.
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Cited By16
Published on Jan 1, 2016
Children possess unique characteristics that set them apart from adults and that create challenges for the conduct of HTA for hospital-based, community-based and regional policy decision-making. Evidence cannot be extrapolated from adult studies for policy-making governing child health. Methods for child health economic evaluation and HTA need to be improved to ensure that adoption and policy decision-making are evidence-based. TASK (Technology Assessment at Sick Kids) was established within the...
Leiyu Shi42
Estimated H-index: 42
(Johns Hopkins University),
Chien Chou Chen2
Estimated H-index: 2
(Ling Tung University)
+ 2 AuthorsRuwei Hu2
Estimated H-index: 2
(Johns Hopkins University)
Objective: The purpose of this study was to examine racial and socioeconomic disparities in access to primary care among people with chronic conditions. Methods: Data for this study were taken from the household component of the 2010 Medical Expenditure Panel Survey. The analysis primarily focused on adults ≥18 years old. Logistic regressions were conducted among people with chronic conditions to compare primary care attributes between each minority group and their non-Hispanic white counterpart...
Published on Nov 25, 2011
Casey M. Calkins25
Estimated H-index: 25
Keith T. Oldham47
Estimated H-index: 47
Published on May 1, 2008in Seminars in Pediatric Surgery2.46
Casey M. Calkins25
Estimated H-index: 25
(Children's Hospital of Wisconsin)
Outcomes are, simply put, why a surgeon comes to work each day. For decades, surgeons have insisted on a regular self-examination of outcomes to ensure the optimal treatment of our patients. Clinical research in pediatric surgery has largely subsisted on outcome analysis as it relates to the rudimentary end-result of an operation, utilizing variables such as mortality, operative time, specific complication rates, and hospital length of stay to name a few. Recently, outcomes research has become a...
Published on Jun 1, 2004in Pediatrics5.40
Christina Bethell23
Estimated H-index: 23
(OHSU: Oregon Health & Science University),
Colleen Reuland4
Estimated H-index: 4
(OHSU: Oregon Health & Science University)
+ 1 AuthorsEdward L. Schor13
Estimated H-index: 13
(Commonwealth Fund)
Objective. To generate a national picture of performance in the area of preventive and developmental services for children aged 4 to 35 months using 4 composite quality measures in the areas of 1) anticipatory guidance and parental education, 2) screening for family psychosocial risks, 3) screening for smoking and drug and alcohol use in the home, and 4) provision of family-centered care. Methods. Data from the National Survey on Early Childhood Health ( N = 2068) were used to calculate the 4 co...
Published on Apr 1, 2004in Medical Care3.79
Christopher B. Forrest45
Estimated H-index: 45
Children have been poorly represented in clinical studies and health services research. However, this situation is changing rapidly, and the number of research studies focusing on child outcomes is steadily increasing. The special characteristics of childhood related to health care-developmental change, dependency on adults, different disease epidemiology from adults, and unique demographic characteristics-pose methodologic challenges to researchers. These characteristics also argue for an expan...
Published on Jan 1, 2003in Pediatrics5.40
Christopher B. Forrest45
Estimated H-index: 45
Scott A. Shipman1
Estimated H-index: 1
+ 1 AuthorsMarlene R. Miller41
Estimated H-index: 41
Objective. Pediatric outcomes research examines the effects of health care delivered in everyday medical settings on the health of children and adolescents. It is an area of inquiry in its nascent stages of development. Methods. We conducted a systematic literature review that covered articles published during the 6-year interval 1994-1999 and in 39 peer-reviewed journals chosen for their likelihood of containing child health services research. This article summarizes the article abstraction, re...
Published on Jun 1, 2002in The Journal of Applied Behavioral Science1.68
Lynne C. Huffman24
Estimated H-index: 24
Cheryl Koopman62
Estimated H-index: 62
+ 6 AuthorsJennifer Dyer-Friedman9
Estimated H-index: 9
(Stanford University)
Evaluation research and outcomes measurement in the arena of behavioral health services for children must be adapted for the community agency setting. Through evaluation research, it is possible to address service goals as well as more traditional academic research goals. This article examines a variety of activities that have been implemented to evaluate children’s behavioral and educational services in a Northern California non-profit community agency. It is noted that there are multiple forma...
Merle Kataoka-Yahiro10
Estimated H-index: 10
(U.H.: University of Hawaii at Manoa),
Frances Munet‐Vilaro1
Estimated H-index: 1
(UW: University of Washington)
Purpose To review the literature on barriers to availability, access, and utilization of preventive health care for young children three to five years of age and their families and to discuss the role of nurse practitioners (NPs) in future research, education, and practice in this area. Data Sources A comprehensive literature search was conducted of online material and CINAHL and Medline (CD-ROM 1990 to present). In addition, experts in this area were asked to recommend extra reading materials. ...
Published on Jan 1, 2001in Ambulatory Pediatrics
Sherrie H. Kaplan44
Estimated H-index: 44
Sheldon Greenfield70
Estimated H-index: 70
(Tufts University)
+ 2 AuthorsRichard J. Grand56
Estimated H-index: 56
(Tufts University)
Effectiveness research represents a number of methodologic challenges not shared with randomized, controlled clinical trials. This practice-based research attempts to translate clinical practices to a wide variety of different practice settings and situations and to diverse patient subgroups. However, because study designs most often used in the conduct of effectiveness research limit the ability to establish firm causal links between medical care and outcomes, it is important to address key met...
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