scholarly journals Effects of universal critical CHD screening of neonates at a mid-sized California congenital cardiac surgery centre

2021 ◽  
pp. 1-8
Author(s):  
Robin Miller ◽  
Timothy Martens ◽  
Upinder Jodhka ◽  
Jade Tran ◽  
Richard Lion ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Heart Surgery ◽  
Operative Mortality ◽  
Pulmonary Atresia ◽  
The United States ◽  
Adverse Outcomes ◽  
Actuarial Survival ◽  
Children's Hospital ◽  
Loma Linda University ◽  
Children’S Hospital

Abstract Introduction: CHD affects over 1 million children in the United States. Studies show decreased mortality from CHD with newborn cardiac screening. California began a screening programme on 1 July, 2013. We evaluated the effect of mandatory screening on surgical outcomes at Loma Linda University Children’s Hospital since 1 July, 2013. Methods: We evaluated all infants having congenital heart surgery at Loma Linda University Children’s Hospital between 1 July, 2013 and 31 December, 2018. Primary target diagnoses include hypoplastic left heart syndrome, pulmonary atresia with intact ventricular septum, tetralogy of Fallot, total anomalous pulmonary venous return, transposition of the great arteries, tricuspid atresia, and truncus arteriosus. Secondary target diagnoses include aortic coarctation, double outlet right ventricle, Ebstein anomaly, interrupted aortic arch, and single ventricle. Patients were stratified by timing of diagnosis (pre-screen, screen positive, and screen negative). Primary end points were post-operative length of stay, operative mortality, absolute mortality, and actuarial survival. Results: The cohort included 274 infants. Of these, 79% were diagnosed prior to screening (46% prenatally). Only 38% of those screened were positive, with 13% of the cohort having a “missed diagnosis.” Conclusions: Primary targets were more likely to be diagnosed by screening (53%), while secondary targets were unlikely to be diagnosed by screening (10%) (p = 0.004). Outcomes such as length of stay, operative mortality, and actuarial survival were not different based on timing of diagnosis (p > 0.05). Despite late diagnosis, those not diagnosed until after screening did not have adverse outcomes.

scholarly journals Pediatric Tetanus in Central Pennsylvania

2018 ◽  
Vol 8 (4) ◽  
pp. 358-360
Author(s):  
Bilaal S Ahmed ◽  
Michael J Beck ◽  
Gregory Williamson ◽  
Jessica E Ericson ◽  
Parvathi Kumar
Keyword(s):  
United States ◽  
Length Of Stay ◽  
Medical Record ◽  
Electronic Medical Record ◽  
The United States ◽  
Median Length ◽  
Children's Hospital ◽  
Central Pennsylvania ◽  
Penn State ◽  
Children’S Hospital

Abstract Approximately 20% of the nationally reported tetanus infections in children aged 0 to 14 years that occurred in the United States between 2005 and 2015 were treated at Penn State Children’s Hospital. With an electronic medical record search, we identified 5 cases of pediatric tetanus; 100% of these cases occurred in unimmunized children. Their median length of stay was 10 days, and the costs were significant.

Introduction to the 2015 Supplement toCardiology in the Young: Proceedings of the 2015 International Pediatric Heart Failure Summit of Johns Hopkins All Children’s Heart Institute

2015 ◽  
Vol 25 (S2) ◽  
pp. 1-7 ◽  
Author(s):  
Jeffrey P. Jacobs
Keyword(s):  
Heart Failure ◽  
Heart Surgery ◽  
The United States ◽  
South Florida ◽  
Heart Institute ◽  
Children's Hospital ◽  
Pediatric Heart Surgery ◽  
International Pediatric ◽  
Children’S Hospital ◽  
Pediatric Heart Failure

AbstractIn the United States of America alone, ~14,000 children are hospitalised annually with acute heart failure. The science and art of caring for these patients continues to evolve.The International Pediatric Heart Failure Summit of Johns Hopkins All Children’s Heart Institute was held on 4 and 5 February, 2015. The 2015 International Pediatric Heart Failure Summit of Johns Hopkins All Children’s Heart Institute was funded through the Andrews/Daicoff Cardiovascular Program Endowment, a philanthropic collaboration between All Children’s Hospital and the Morsani College of Medicine at the University of South Florida (USF). Sponsored by All Children’s Hospital Andrews/Daicoff Cardiovascular Program, the Johns Hopkins All Children’s Heart Institute International Pediatric Heart Failure Summit assembled leaders in clinical and scientific disciplines related to paediatric heart failure and created a multi-disciplinary “think-tank”. Information about George R. Daicoff, MD, and Ed and Sarainne Andrews is provided in this introductory manuscript to the 2015 Supplement toCardiology in the Youngentitled: “Proceedings of the 2015 International Pediatric Heart Failure Summit of Johns Hopkins All Children’s Heart Institute”. Dr Daicoff founded the All Children’s Hospital Pediatric Heart Surgery programme and directed this programme for over two decades. Sarainne Andrews made her generous bequest to All Children’s Hospital in honour of her husband Ed and his friendship with Dr Daicoff in order to support cardiovascular surgery research efforts.

Analysis of the Effects of Applying Federal Diagnosis-Related Grouping (DRG) Guidelines to a Population of High-Risk Newborn Infants

PEDIATRICS ◽  
1985 ◽  
Vol 76 (1) ◽  
pp. 104-109
Author(s):  
Ronald L. Poland ◽  
Robert O. Bollinger ◽  
Mary P. Bedard ◽  
Sanford N. Cohen
Keyword(s):  
High Risk ◽  
Length Of Stay ◽  
Geometric Mean ◽  
Tertiary Care ◽  
Newborn Infants ◽  
Frequency Distributions ◽  
Federal Register ◽  
Children's Hospital ◽  
Lengths Of Stay ◽  
Children’S Hospital

Length of stay data collected for high-risk newborn infants admitted to a tertiary care children's hospital neonatal unit over a 6-year period were compared with mean and outlier lengths of stay published in the Federal Register as part of a proposed system for prospective payment of hospital cost by diagnosis-related groupings (DRGs). We found that the classification system for newborns markedly underestimated the number of days required for the treatment of these infants. The use of the geometric mean instead of the arithmetic mean as the measure of central tendency was a significant contributor to the discrepancy, especially in those sub-groups with bimodal frequency distributions of lengths of stay. Another contributor to the discrepancy was the lack of inborn patients in the children's hospital cohort. The system of prospective payments, as outlined, does not take into account several factors that have a strong influence on length of stay such as birth weight (which requires more than three divisions to serve as an effective predictor), surgery, outborn status, and ventilation. Implementation of the system described in the Federal Register would severely discourage tertiary care referral hospitals from providing neonatal intensive care.

Hospital Use Patterns for Children in the United States, 1983 and 1984

PEDIATRICS ◽  
1987 ◽  
Vol 80 (4) ◽  
pp. 481-490 ◽  
Author(s):  
Lola Jean Kozak ◽  
Catherine Norton ◽  
Margaret McManus ◽  
Eileen McCarthy
Keyword(s):  
Health Status ◽  
Hospital Discharge ◽  
Discharge Rate ◽  
The United States ◽  
National Hospital Discharge Survey ◽  
Children's Hospital ◽  
Use Patterns ◽  
Discharge Rates ◽  
Children’S Hospital ◽  
Hospital Use

The hospital discharge rate of children less than 15 years of age in the United States declined 12% from 1983 to 1984. This was the first time in the 20-year history of the National Hospital Discharge Survey that there was a statistically significant decrease in children's hospital discharge rates in a 1-year period. The change occurred during a period when prospective hospital payment systems were introduced and when prepaid group health plans and alternative systems of providing health care were expanding. The unprecedented decrease in children's hospital use was evaluated using data from the National Hospital Discharge Survey. This is a continuous survey in which data from a national sample of medical records of discharged patients are collected. Children's hospital use rates were reviewed by age, sex, region, and expected principal source of payment. Significant decreases in discharge rates were found for the age group 1 to 4 years and for all children with private insurance. The patterns and changes in hospital use by diagnostic category were also investigated. The major finding was a 19% decrease in children's discharge rate for diseases of the respiratory system. Mortality statistics and data from the National Health Interview Survey were evaluated for indications of changes in children's health status or use of physician services accompanying the decline in hospital use. Although there were fewer deaths due to respiratory diseases for children less than 5 years of age in 1984 than in 1983, most measures of health status were unchanged. The only significant change in physician use was a decrease in the percentage of acute conditions that were medically attended, also among children less than 5 years of age. It is important to continue monitoring children's hospital use patterns, as well as their health status and use of alternative health services, to further assess the impact of changes in the organization and financing of health services.

DIAGNOSTIC INERTIA

PEDIATRICS ◽  
1961 ◽  
Vol 28 (5) ◽  
pp. 695-696
Author(s):  
R. J. MCKAY
Keyword(s):  
United States ◽  
Patient Care ◽  
The United States ◽  
Interim Report ◽  
Children's Hospital ◽  
Medical Centers ◽  
Pediatric Education ◽  
Children’S Hospital ◽  
Pediatric Services

In this issue of Pediatrics the article entitled "A New Design for Patient Care and Pediatric Education in a Children's Hospital: An Interim Report," by Green and Segar, represents a challenging approach to problems that are of increasing concern to pediatric educators and pediatric services of medical centers throughout the United States. It should be emphasized that the authors' plan is a proposed solution to the problems involved, and that the question as to whether it will constitute an answer will have to await analysis not only of their results but of the results of other approaches to the same problems.

DEFECTIVE STEROIDAL BIOGENESIS IN CONGENITAL ADRENAL HYPERPLASIA

PEDIATRICS ◽  
1958 ◽  
Vol 21 (4) ◽  
pp. 661-672
Author(s):  
Alfred M. Bongiovanni ◽  
Walter R. Eberlein
Keyword(s):  
Research Work ◽  
Assistant Professor ◽  
The United States ◽  
University Of Pennsylvania ◽  
Rockefeller Institute ◽  
Children's Hospital ◽  
Research Division ◽  
Children’S Hospital ◽  
The University

Dr. Alfred M. Bongiovanni is a young man who started research work as an investigator at the Marine Biological Laboratory, Woods Hole, Massachusetts, even before he received his B.S. degree from Villanova College in 1940. While at Villanova, Dr. Bongiovanni received the Kolmer Medal for Excellence in Science. In 1943 he received his M.D. from the University of Pennsylvania, following which he immediately served a 2-year tour of duty in the United States Navy. After discharge from the Navy, he filled residencies at the Children's Hospital of Philadelphia from 1947 to 1949. During the years 1949 and 1950, Dr. Bongiovanni served as Assistant Physician at the Rockefeller Institute in New York and in 1950-51 returned to the Children's Hospital of Philadelphia as Assistant Director of Clinics. In 1951 he was appointed the National Foundation of Infantile Paralysis Fellow to the Research Division of the Children's Hospital of Philadelphia. New opportunities and promotions quickly followed with an appointment as Assistant Professor of Pediatrics at Johns Hopkins in 1952; Senior Research Associate in the Pediatric Endocrine Division and Assistant Professor of Pediatrics at the University of Pennsylvania in 1954; and in 1955 Associate Professor of Pediatrics at the same university. Dr. Bongiovanni is a Diplomate of the American Board of Pediatrics and a member of the Editorial Board of the American Journal of Medical Sciences and of numerous professional societies. In 1956 Dr. Bongiovanni received the Ciba Award. Dr. Bongiovanni has been author of about 50 articles, the great majority of which are on endocrinology and at least 23 of them with Dr. Eberlein, who is the co-recipient with Dr. Bongiovanni of this Award, as a co-author.

The impact of beta-lactam allergy labels on hospitalized children

2020 ◽  
pp. 1-7
Author(s):  
Trahern W. Jones ◽  
Nora Fino ◽  
Jared Olson ◽  
Adam L. Hersh
Keyword(s):  
Length Of Stay ◽  
Pediatric Patients ◽  
The United States ◽  
Adverse Outcomes ◽  
Hospitalized Children ◽  
Beta Lactam ◽  
Healthcare Facilities ◽  
Antibiotic Allergy ◽  
Hospitalization Costs ◽  
The Impact

Abstract Background and objectives: Antibiotic allergy labels are common and are frequently inaccurate. Previous studies among adults demonstrate that β-lactam allergy labels may lead to adverse outcomes, including prescription of broader-spectrum antibiotics, increased costs, and increased lengths of stay, among others. However, data among pediatric patients are lacking, especially in the United States. In this study, we sought to determine the impact of β-lactam allergy labels in hospitalized children with regards to clinical and economic outcomes. Method: This retrospective cohort study included pediatric patients 30 days to 17 years old, hospitalized at Intermountain Healthcare facilities from 2007 to 2017, who received ≥1 dose of an antibiotic during their admission. Patients with β-lactam allergies were matched to nonallergic patients based on age, sex, clinical service line, admission date, academic children’s hospital or other hospital admission, and the presence of chronic, comorbid conditions. Outcomes included receipt of broader-spectrum antibiotics, clinical outcomes including length of stay and readmission, and antibiotic and hospitalization costs. Results: In total, 38,906 patients were identified. The prevalence of antibiotic allergy increased from 0.9% among those < 1 year peaked at 10.6% by age 17. Patients with β-lactam allergy received broader-spectrum antibiotics and experienced higher antibiotic costs than nonallergic controls. However, there were no differences in the length of stay, readmission rates, or total number of days of antibiotics between allergic and nonallergic patients. Conclusions: Hospitalized pediatric patients with β-lactam allergy labels receive broader-spectrum antibiotics and experience increased antibiotic costs. This represents an important opportunity for allergy delabeling and antibiotic stewardship.

scholarly journals The Squibb Travelling Fellowship

1988 ◽  
Vol 12 (10) ◽  
pp. 449-451
Author(s):  
Carol Fitzpatrick
Keyword(s):  
United States ◽  
Trinity College ◽  
Medical Center ◽  
Emotional Adjustment ◽  
The United States ◽  
Children's Hospital ◽  
Trinity College Dublin ◽  
Future Paper ◽  
Children’S Hospital ◽  
The Subject

In 1986 I was awarded the Squibb Travelling Fellowship by the Royal College of Psychiatrists. The funding this provided, combined with funding provided by the Henry Hutchinson Stewart Scholarship in Psychiatry awarded by Trinity College, Dublin, enabled me to spend a three month period in the summer of 1987 at the Children's Hospital Medical Center, Boston, doing research in the area of emotional adjustment in adolescents with chronic physical illnesses. The research will be the subject of a future paper. The purpose of this communication is to outline some of the steps en route between winning the Fellowship and starting on the project at Children's Hospital. The amount of paperwork involved was time consuming, confusing and, at times, overwhelming, and I hope that other doctors planning to travel to the United States to carry out research will benefit from my expeience.

scholarly journals Readiness for an Increase in Congenital Zika Virus Infections in the United States: Geographic Distance to Pediatric Subspecialist Care

2018 ◽  
Vol 13 (03) ◽  
pp. 476-486 ◽  
Author(s):  
Jeanne Bertolli ◽  
Joseph Holbrook ◽  
Nina D. Dutton ◽  
Bryant Jones ◽  
Nicole F. Dowling ◽  
...  
Keyword(s):  
United States ◽  
Zika Virus ◽  
Full Range ◽  
Geographic Distance ◽  
Virus Transmission ◽  
The United States ◽  
Travel Distance ◽  
Mosquito Vector ◽  
Children's Hospital ◽  
Children’S Hospital

ABSTRACTObjectiveThe study’s purpose was to investigate readiness for an increase in the congenital Zika infection (CZI) by describing the distribution of pediatric subspecialists needed for the care of children with CZI.MethodsWe applied county-level subspecialist counts to US maps, overlaying the geocoded locations of children’s hospitals to assess the correlation of hospital and subspecialist locations. We calculated travel distance from census tract centroids to the nearest in-state children’s hospital by state (with/without &gt; 100 reported adult Zika virus cases) and by regions corresponding to the likely local Zika virus transmission area and to the full range of the mosquito vector. Travel distance percentiles reflect the population of children &lt; 5 years old.ResultsOverall, 95% of pediatric subspecialists across the United States are located in the same county or neighboring county as a children’s hospital. In the states where Zika virus transmission is likely, 25% of children must travel more than 50 miles for subspecialty care; in one state, 50% of children must travel &gt; 100 miles.ConclusionThe travel distance to pediatric subspecialty care varies widely by state and is likely to be an access barrier in some areas, particularly states bordering the Gulf of Mexico, which may have increasing numbers of CZI cases. (Disaster Med Public Health Preparedness. 2019;13:476-486)

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