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Evidence-Based Health Care for Children: What Are We Missing?

April 30, 2010 - With the enactment of comprehensive health reform, reimbursement for a variety of health care services will likely depend on evidence to support that provision. Understanding what constitutes "evidence" will have a profound effect on the range of clinical care provided.

Issue Brief

The Massachusetts Child Psychiatry Access Project: Supporting Mental Health Treatment in Primary Care

March 3, 2010 - Massachusetts has successfully demonstrated the Massachusetts Child Psychiatry Access Project, a program that provides timely telephonic psychiatric and clinical guidance to primary care providers treating children with mental health problems. This study looks into the development and implementation of the project.

Case Study

Development of a New Patient-Based Measure of Pediatric Ambulatory Care

February 2, 2010 - The National Quality Forum has noted that questions about developmental and preventive care would improve the CAHPS pediatric survey. To fill this gap, Commonwealth Fund–supported researchers developed and tested new questions and survey protocols to assess the preventive and developmental care provided by pediatricians.

Literature Abstract

Improving Pediatric Preventive Care

February 1, 2010 - In this commentary in Academic Pediatrics, Commonwealth Fund vice president Edward L. Schor, M.D., contends that pediatricians rarely have sufficient time or enough specific information about children’s development and families’ circumstances to offer highly targeted, individualized care during preventive visits.

Literature Abstract

Physician Effects on Racial and Ethnic Disparities in Patients’ Experiences of Primary Care

February 1, 2010 - A Commonwealth Fund–supported study published in the Journal of General Internal Medicine investigated the extent to which racial and ethnic disparities can be attributed to differences within physician practices—meaning they are potentially related to discrimination or differential treatment—or to differences between practices, an indication that minority patients tend to receive treatment in low-performing practices.

Literature Abstract

Disparities in Long-Term Care: Building Equity into Market-Based Reforms

February 1, 2010 - Rather than “lifting all boats,” some market-based policies may exacerbate disparities in the quality of long-term care, according to a Commonwealth Fund–supported study published in Medical Care Research and Review.

Literature Abstract

Coming Out of Crisis: Patient Experiences in Primary Care in New Orleans, Four Years Post-Katrina—Findings from The Commonwealth Fund 2009 Survey of Clinic Patients in New Orleans

January 15, 2010 - A new Commonwealth Fund survey of safety-net clinic patients in New Orleans finds that, despite being disproportionately low-income and uninsured, these patients had fewer problems affording care and fewer instances of medical debt and inefficient care than most U.S. adults. The findings suggest that the locally based clinics could serve as a model for delivering primary care to vulnerable populations elsewhere.

Fund Report

Implementing Electronic Health Record-Based Quality Measures for Developmental Screening

December 1, 2009 - This Fund–supported study published in Pediatrics that evaluated the use of electronic health records (EHRs) in six early-adopting health care organizations found that EHRs can facilitate the screening of young children for developmental delays and can help flag patients with abnormal results.

In the Literature

Achieving Effective Care Coordination in the Medical Home

November 24, 2009 - Drawing on a recent Commonwealth Fund report, Making Care Coordination a Critical Component of the Pediatric Health System: A Multidisciplinary Framework, the authors of this Fund-supported article discuss strategies for coordinating care in medical homes. They report that having committed leadership and a process to shift care delivery from "reactive encounters" to "proactive interactions" are key to success.

Literature Abstract

Using Implementation and Dissemination Concepts to Spread 21st-Century Well-Child Care at a Health Maintenance Organization

November 17, 2009 - For this Fund-supported study in The Permanente Journal, researchers explored the options for disseminating a model of well-child care that is parent-centered and team-based and includes developmental and preventive visits.

Literature Abstract

The Use of Internet-Based Technology to Tailor Well-Child Care Encounters

November 17, 2009 - For this Fund-supported study in The Permanente Journal, researchers explored the options for disseminating a model of well-child care that is parent-centered and team-based and includes developmental and preventive visits.

In the Literature

Racial and Ethnic Disparities in the Use of High-Volume Hospitals

November 16, 2009 - Fund-supported researchers reported in Inquiry that minority patients in the New York City area are significantly less likely than whites to be treated at high-volume hospitals for services for which high volume is associated with better outcomes.

In the Literature

Access to Care and Use of Preventive Services by Hispanics: State-Based Variations from 1991 to 2004

November 13, 2009 - Access to doctors and use of mammography, cholesterol testing, and other preventive services improved for both white and Hispanic patients nationally from 1991 to 2004, Fund-supported researchers reported in the journal Medical Care. Gaps in access to care, however, widened between whites and Hispanics in individual states, including Texas and Florida.

In the Literature

Using Insurance Standards and Policy Levers to Build a High Performance Health System

November 6, 2009 - This Commonwealth Fund issue brief examines an unprecedented use of state health insurance regulatory authority to promote health system reform. In Rhode Island, regulators have used this authority to implement a set of standards to promote increased affordability through a series of requirements aimed at strengthening and expanding the state's primary care infrastructure.

Issue Brief

State Hospital Rate-Setting Revisited

October 27, 2009 - In an attempt to control rapid growth in hospital costs, beginning in the mid-1970s seven states implemented rate-setting programs to regulate hospital payments. Although all but two have since been discontinued, these states' experiences offer lessons for policymakers as they continue searching for ways to control rising health care costs.

Issue Brief