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1

SAPIN, SAMUEL O. "Managed Care." Pediatrics 90, no. 2 (August 1, 1992): 278. http://dx.doi.org/10.1542/peds.90.2.278.

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To the Editor.— The recent report in Pediatrics1 of a random survey of American Academy of Pediatrics Fellows, titled "Barriers to Pediatric Referral in Managed Care Systems" paints a picture of managed care with brushstrokes which are much too broad. Managed care is an extremely heterogeneous entity and the authors of the report do not emphasize sufficiently the fact that pediatricians in certain types of managed care systems practice with no barriers to appropriate referrals for subspecialty or inpatient care.
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2

Johnston, Donna L., Tracy A. Hentz, and Debra L. Friedman. "Pediatric Palliative Care." Journal of Pediatric Pharmacology and Therapeutics 10, no. 4 (October 1, 2005): 200–214. http://dx.doi.org/10.5863/1551-6776-10.4.200.

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Pediatric palliative care provides benefit to children living with life-threatening or terminal conditions. Palliative care should be available to all seriously ill children. Palliative care includes the treatment of symptoms such as pain, nausea, dyspnea, constipation, anorexia, and sialorrhea. This care can occur in a variety of settings, from home to hospice to hospital, and must include bereavement care and follow up after the death of a child. There are many challenges in pediatric palliative care, but continued research into this important area of pediatrics will lead to improvements in the care of children with life-threatening illnesses.
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3

Podila, Pradeep S. B., Vikki Nolan, Anjelica Christina Saulsberry, Sheila Anderson, Jason R. Hodges, Jerlym Porter, and Jane S. Hankins. "Interruption in Care Continuity during Healthcare Transition from Pediatric to Adult Care Increases Acute Care Utilization." Blood 132, Supplement 1 (November 29, 2018): 2226. http://dx.doi.org/10.1182/blood-2018-99-115789.

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Abstract Background: Among youth with sickle cell disease (SCD), morbidity and mortality substantially increase following departure from pediatric care. Care continuity following transfer from pediatric to adult-centered care is paramount to ensure maintenance of health care delivery and reduce the risk of poor clinical outcomes. The American Academy of Pediatrics recommends matriculation in adult care within 6 months from leaving pediatric care for patients with special health care needs. Failure to transition from pediatric to adult care among youth with SCD may contribute to frequent disease complications and early death. No formal analysis has been conducted to quantify the risk of care interruption as youth transition from pediatric to adult care on the rate of acute health care utilization. We tested the hypothesis that patients who interrupted care for more than 6 months as they moved from the pediatric to the adult-centered care setting would have higher frequency of acute health care utilization. Methods: With IRB approval, we conducted a retrospective review of the rate of acute care utilization among patients with SCD who were transitioned from the pediatric sickle cell program at St. Jude Children's Research Hospital to the adult sickle cell program at Methodist University Hospital, Memphis TN between January 2014 and December 2017. We compared the rates of emergency department (ED) and inpatient utilization among those who established care >6 months from completing pediatric care (interrupted care continuity) and those who established adult care within 6 months from completing pediatric care (uninterrupted care continuity). We used person-time rates to compare the rates of emergency department and inpatient encounters per patient between the two care continuity groups. Results: Between January 2014 and December 2017 there were 172 patients with SCD who completed pediatric care and established adult care: 63 of them had a latency time from pediatric to adult care >6 months and 109 had a latency time from pediatric to adult care ≤6 months. Their follow-up since matriculation in adult care was 2245 and 2197 person-years for interrupted and uninterrupted care continuity groups, respectively The median (range) age upon establishing adult care was 20 (range, 20 to 24) years and 18 (range, 18 to 19) years for the interrupted and uninterrupted care continuity groups, respectively. Patients who interrupted care >6 months after leaving pediatric care had an incidence rate of 0.18 ED visits/person-year compared to 0.09 ED visits/person-year among those who completed the first visit within 6 months from leaving pediatric care (IRR 0.48, 95%CI 0.40-0.57, p<0.0001) (Figure panels A and B). Patients who interrupted care >6 months after leaving pediatric care had an incidence rate of 0.09 inpatient visits/person-year compared to 0.04 inpatient visits/person-year among those who completed the first visit within 6 months from leaving pediatric care (IRR 0.42 (95%CI 0.32-0.54, p<0.0001) (Figure panels C and D). Conclusions: The latency time from pediatric to adult care may impact the frequency of acute care utilization among youth with SCD. Patients who do not establish adult care within 6 months from leaving pediatric care, as recommended by the American Academy of Pediatrics, are at risk of experiencing greater ED and inpatient visits than those who establish care within 6 months from leaving pediatric care. Efforts to avoid care interruptions during the health care transition period are important to ensure optimal health outcomes among youth with SCD. Disclosures Hankins: NCQA: Consultancy; bluebird bio: Consultancy; Novartis: Research Funding; Global Blood Therapeutics: Research Funding.
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4

Green, Morris. "Pediatric Education and the Care of the Person." Pediatrics 78, no. 3 (September 1, 1986): 431–37. http://dx.doi.org/10.1542/peds.78.3.431.

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Pediatric education is preeminently concerned with the care of the person—the child, the parent, and the physician. Such personalized care can no longer be taken for granted. In both its scientific and humanistic qualities, it is being threatened by nonselective cost cutting. These changes will not spare pediatric education. The public, greatly concerned about the humanistic character of today's physicians, needs to better understand that pediatric education is fully committed to being humanistically as well as scientifically responsive to the needs of the times. Pediatrics should be defined as the specialty of growth, development, and adaptation, with adaptation offering a bridge between the biomedical and the psychosocial aspects of child health. Pediatric education needs both long- and short-term views. Opportunities to explore new pediatric roles have become time limited. A national strategic plan for pediatric education is needed. Because it takes more than the residency years to become a seasoned pediatrician, academic departments have a shared responsibility with the American Academy of Pediatrics, at the national and chapter level, to jointly fashion effective and relevant continuing education experiences.
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5

Chasco, Deborah. "Core Handbooks in Pediatrics, Pediatric Primary Care: Well-Child Care." Clinical Nurse Specialist 15, no. 6 (November 2001): 295. http://dx.doi.org/10.1097/00002800-200111000-00016.

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6

Bhatt-Mehta, Varsha, Marcia L. Buck, Allison M. Chung, Elizabeth Anne Farrington, Tracy M. Hagemann, David S. Hoff, Joseph M. LaRochelle, et al. "Recommendations for Meeting the Pediatric Patient's Need for a Clinical Pharmacist: A Joint Opinion of the Pediatrics Practice and Research Network of the American College of Clinical Pharmacy and the Pediatric Pharmacy Advocacy Group." Journal of Pediatric Pharmacology and Therapeutics 17, no. 3 (December 1, 2012): 281–91. http://dx.doi.org/10.5863/1551-6776-17.3.281.

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Children warrant access to care from clinical pharmacists trained in pediatrics. The American College of Clinical Pharmacy Pediatrics Practice and Research Network (ACCP Pediatrics PRN) released an opinion paper in 2005 with recommendations for improving the quality and quantity of pediatric pharmacy education in colleges of pharmacy, residency programs, and fellowships. While progress has been made in increasing the availability of pediatric residencies, there is still much to be done to meet the direct care needs of pediatric patients. The purpose of this Joint Opinion paper is to outline strategies and recommendations for expanding the quality and capacity of pediatric clinical pharmacy practitioners by 1) elevating the minimum expectations for pharmacists entering practice to provide pediatric care; 2) standardizing pediatric pharmacy education; 3) expanding the current number of pediatric clinical pharmacists; and 4) creating an infrastructure for development of pediatric clinical pharmacists and clinical scientists. These recommendations may be used to provide both a conceptual framework and action items for schools of pharmacy, health care systems, and policymakers to work together to increase the quality and quantity of pediatric training, practice, or research initiatives.
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7

DeSpirito, Anthony P., and Sarah E. Brotherton. "Primary Care Pediatricians." Pediatrics 93, no. 2 (February 1, 1994): 343. http://dx.doi.org/10.1542/peds.93.2.343.

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Lately, the relatively low proportion of physicians who practice primacy care medicine has concerned many, yet exact figures are lacking, given the variation in the methods used for calculation. To this end, we recently surveyed US pediatric residency programs about their residents who finished training in 1992. This was accomplished through the aid of many of the program directors and of members of the Board of Directors of the American Academy of Pediatrics. Through our correspondence, 60% of the programs provided the following information: approximately 55% of graduating residents were planning to enter pediatric practice directly and 42% were planning to enter a subspecialty fellowship.
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8

Vardell, Emily. "Pediatric Care Online: A Pediatric Point-of-Care Tool." Medical Reference Services Quarterly 35, no. 2 (April 2, 2016): 204–14. http://dx.doi.org/10.1080/02763869.2016.1152145.

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9

Rhee, Eileen, and Wynne Morrison. "Pediatric Palliative Care and the Pediatric Intensive Care Unit." Current Pediatrics Reports 6, no. 2 (April 28, 2018): 166–72. http://dx.doi.org/10.1007/s40124-018-0169-4.

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10

LOBECK, CHARLES C. "The Future of Primary Care." Pediatrics 88, no. 1 (July 1, 1991): 187. http://dx.doi.org/10.1542/peds.88.1.187.

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To the Editor.— As a pediatrician who has been a medical school administrator for almost 17 years, I am troubled by the lack of pediatric leadership in the primary care movement. Joel Alpert1 calls attention to the failure of the discipline to respond within itself to the need for change in pediatric education. I am concerned about a larger issue. At the time of the Millis Commission report in 1966, pediatrics was the only clinical discipline active in primary care.
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11

KHAN, HUMAYUN IQBAL, NAILA KHALIQ, and MUHAMMAD FAHEEM AFZAL. "PEDIATRIC INTENSIVE CARE UNIT." Professional Medical Journal 13, no. 03 (June 25, 2006): 358–61. http://dx.doi.org/10.29309/tpmj/2006.13.03.4982.

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Intensive care is predominantly concerned with the managementof patients with acute life threatening conditions in a specialized unit. Children having acute neurological deterioration,respiratory distress, cardiovascular compromise, severe infections and accidental poisonings constitute the majoradmission to a pediatric intensive care unit. Objective: To document the number, disease pattern and outcome ofpatients admitted to Pediatric intensive care unit. Design: Descriptive study. Place and Duration: The study wasconducted in the intensive care unit of department of Pediatrics, King Edward Medical University/Mayo hospital, Lahorefrom July 01, 2004 to June 30, 2005. Patients and Methods: The data of all the admitted patients was analyzed forage, sex, cause of admission and outcome. Results: A total of 1012 children were admitted during the study period.Among them 59.68% were male and 40.32% were female. Bronchopneumonia was the major cause of admission(29.05%) followed by septicemia (14.43%), acute bacterial meningitis (8.1%), acute watery diarrhea (6.92%), congenitalheart diseases (5.14%), tetanus (3.75%) ,acute myocarditis (2.67%) and others (29.94%) including acute bronchialasthma, hepatic encephalopathy, diabetic ketoacidosis, encephalitis, tuberculous meningitis, accidental poisoning andGuillain-Barre syndrome. Out of total admissions, 64.43% were shifted to different units of the department, 4.05%discharged in satisfactory condition, 9.49% left against medical advice (LAMA) and 22.03% died. The case fatality ofsepticemia (65.07%) was highest. Conclusion: Bronchopneumonia and septicemia were the major causes ofadmission while case fatality was highest for septicemia in intensive care unit.
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12

Daptardar, Sayali. "Nosocomial Infections in Pediatric Intensive Care Unit." International Journal of Trend in Scientific Research and Development Volume-2, Issue-4 (June 30, 2018): 940–45. http://dx.doi.org/10.31142/ijtsrd14153.

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13

Allport, Brandon S., Barry S. Solomon, and Sara B. Johnson. "The Other Parent: An Exploratory Survey of Providers’ Engagement of Fathers in Pediatric Primary Care." Clinical Pediatrics 58, no. 5 (February 14, 2019): 555–63. http://dx.doi.org/10.1177/0009922819829032.

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Although father engagement in pediatric care is associated with positive child health outcomes, pediatric primary care providers (PCPs) often focus on the mother-child dyad. This study sought to characterize pediatric PCPs’ engagement of fathers in care. Pediatric PCPs affiliated with an academic health system were invited to complete an online survey. The primary outcome was the proportion of providers who routinely implement American Academy of Pediatrics recommendations for father engagement. There were 100 respondents. Of the 23 recommended practices for engaging fathers, 18 were routinely implemented by <50% of respondents. The least routinely implemented practices were parenting skills support (4%) and perinatal depression screening (5%). The most commonly endorsed barriers included lack of father attendance at visits (91%) and time constraints (75%). Despite the American Academy of Pediatrics recommendations, pediatric PCPs do not routinely engage fathers in care. Effective strategies are needed to reduce barriers and improve father engagement among pediatric providers.
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14

Bauchner, Howard. "The Pediatric Report Card for Preventive Services." Pediatrics 95, no. 6 (June 1, 1995): 930–34. http://dx.doi.org/10.1542/peds.95.6.930.

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Health care reform and consolidation within the health care industry has led to greater interest in measuring the quality of care that children receive. Remarkably little is known about measuring the quality of ambulatory services in pediatrics, but nevertheless there is growing interest in "grading" the services provided by health delivery systems. Health care "report cards" are a cornerstone of managed competition—a set of quality indicators that will allow consumers to select the health care plan that best meets their needs.1,2 What should a report card for pediatric preventive services include? Traditionally, many insurers have reported immunization rates, but little else with respect to children.3,4
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15

Iglesias, Simone, and Ana Cristina Zollner. "Pediatric palliative care." Residência Pediátrica 6, s1 (2016): 46–54. http://dx.doi.org/10.25060/residpediatr-2016.v6s1-10.

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16

Brink, Susan, Rebecca Martin, Deborah Golden, and Leigh Smith. "Primary pediatric care." Journal of Adolescent Health Care 6, no. 3 (May 1985): 201–5. http://dx.doi.org/10.1016/s0197-0070(85)80018-8.

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17

Lotstein, Debra S., and Lonnie K. Zeltzer. "Pediatric palliative care." Journal of Pain and Symptom Management 26, no. 5 (November 2003): 1062–63. http://dx.doi.org/10.1016/s0885-3924(03)00369-5.

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18

Purdue, Gary F., John L. Hunt, and Agnes M. Burris. "Pediatric burn care." Clinical Pediatric Emergency Medicine 3, no. 1 (March 2002): 76–82. http://dx.doi.org/10.1016/s1522-8401(02)90019-4.

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19

Zernikow, Boris, Erik Michel, Finella Craig, and Brian J. Anderson. "Pediatric Palliative Care." Pediatric Drugs 11, no. 2 (2009): 129–51. http://dx.doi.org/10.2165/00148581-200911020-00004.

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20

Heimel, Albert J. "Pediatric hospital care." Postgraduate Medicine 80, no. 6 (November 1986): 245. http://dx.doi.org/10.1080/00325481.1986.11699604.

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21

Zarbock, Sarah F. "Pediatric hospice care." Home Care Provider 4, no. 6 (December 1999): 224–25. http://dx.doi.org/10.1016/s1084-628x(99)90087-4.

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22

Mayer, Kathleen M., and Doris J. Biester. "Pediatric trauma care." Journal of Pediatric Nursing 10, no. 6 (December 1995): 385–86. http://dx.doi.org/10.1016/s0882-5963(05)80037-5.

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23

Moody, Karen, Linda Siegel, Kathryn Scharbach, Leslie Cunningham, and Rabbi Mollie Cantor. "Pediatric Palliative Care." Primary Care: Clinics in Office Practice 38, no. 2 (June 2011): 327–61. http://dx.doi.org/10.1016/j.pop.2011.03.011.

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24

Norris, Sarah, Sheera Minkowitz, and Kathryn Scharbach. "Pediatric Palliative Care." Primary Care: Clinics in Office Practice 46, no. 3 (September 2019): 461–73. http://dx.doi.org/10.1016/j.pop.2019.05.010.

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25

Chaffee, Sara. "Pediatric palliative care." Primary Care: Clinics in Office Practice 28, no. 2 (June 2001): 365–90. http://dx.doi.org/10.1016/s0095-4543(05)70028-2.

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26

Macintire, Douglass K. "Pediatric Intensive Care." Veterinary Clinics of North America: Small Animal Practice 29, no. 4 (July 1999): 971–88. http://dx.doi.org/10.1016/s0195-5616(99)50085-5.

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27

LaRovere, Kerri L., Sarah A. Murphy, Robin Horak, Patrick Vittner, Kush Kapur, Mark Proctor, and Robert C. Tasker. "Pediatric Neurocritical Care." Pediatric Critical Care Medicine 19, no. 11 (November 2018): 1039–45. http://dx.doi.org/10.1097/pcc.0000000000001708.

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28

Pineda, Jose A., and David D. Limbrick. "Pediatric Neurocritical Care." Pediatric Critical Care Medicine 20, no. 1 (January 2019): 97–98. http://dx.doi.org/10.1097/pcc.0000000000001771.

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29

Wolf, A. "Pediatric Critical Care." British Journal of Anaesthesia 108, no. 1 (January 2012): 171. http://dx.doi.org/10.1093/bja/aer414.

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30

GLASS, NANCY L., MURRAY A. POLLACK, and URS E. RUTTIMANN. "Pediatric intensive care." Critical Care Medicine 14, no. 3 (March 1986): 222–26. http://dx.doi.org/10.1097/00003246-198603000-00011.

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31

Levine, Stephen D. "Pediatric Intensive Care." Critical Care Medicine 16, no. 12 (December 1988): 1259. http://dx.doi.org/10.1097/00003246-198812000-00027.

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32

Talati, Erin D. "Pediatric Critical Care." Critical Care Medicine 42, no. 3 (March 2014): e258. http://dx.doi.org/10.1097/ccm.0000000000000235.

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33

Fink, Ericka L. "Pediatric Neurocritical Care." Critical Care Medicine 42, no. 10 (October 2014): e689. http://dx.doi.org/10.1097/ccm.0000000000000474.

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34

Wong, Hector R., and Thomas P. Shanley. "Pediatric critical care." Critical Care Clinics 19, no. 3 (July 2003): xiii—xiv. http://dx.doi.org/10.1016/s0749-0704(03)00031-9.

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35

Benton, Tami D., Gregory K. Fritz, and Gary R. Maslow. "Pediatric Integrated Care." Child and Adolescent Psychiatric Clinics of North America 26, no. 4 (October 2017): i. http://dx.doi.org/10.1016/s1056-4993(17)30086-x.

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36

Kavanaugh, Karen, and Vicky R. Bowden. "Pediatric Palliative Care." MCN, The American Journal of Maternal/Child Nursing 32, no. 5 (September 2007): 269. http://dx.doi.org/10.1097/01.nmc.0000287993.05555.64.

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37

Gilmer, Mary Jo. "Pediatric palliative care." Critical Care Nursing Clinics of North America 14, no. 2 (June 2002): 207–14. http://dx.doi.org/10.1016/s0899-5885(01)00013-2.

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38

Tidwell, Jerithea, and Brennan Lewis. "Pediatric Critical Care." Critical Care Nursing Clinics of North America 29, no. 2 (June 2017): i. http://dx.doi.org/10.1016/s0899-5885(17)30018-7.

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39

Morgan, Brenda A. "Pediatric Home Care." Home Healthcare Nurse: The Journal for the Home Care and Hospice Professional 7, no. 4 (July 1989): 39. http://dx.doi.org/10.1097/00004045-198907000-00013.

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40

Harmer, Louise A. "Pediatric Home Care." Home Healthcare Nurse: The Journal for the Home Care and Hospice Professional 16, no. 7 (July 1998): 485–86. http://dx.doi.org/10.1097/00004045-199807000-00017.

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41

Chin, Loh Ee, Lam Chee Loong, Chin Cheuk Ngen, Tan Seng Beng, Chin Shireen, Wong Sook Kuan, and Rosalie Shaw. "Pediatric Palliative Care." American Journal of Hospice and Palliative Medicine® 31, no. 8 (October 21, 2013): 833–35. http://dx.doi.org/10.1177/1049909113509001.

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42

Nugent, Stephen K. "Pediatric Critical Care." Critical Care Medicine 21, no. 4 (April 1993): 638. http://dx.doi.org/10.1097/00003246-199304000-00034.

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43

Oh, W., M. S. Cairo, and F. Desposito. "PEDIATRIC/ADOLESCENT CARE." Nurse Practitioner 24, no. 12 (December 1999): 63. http://dx.doi.org/10.1097/00006205-199912000-00010.

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44

Berman, Stephen. "Primary Pediatric Care." Journal of Developmental & Behavioral Pediatrics 9, no. 1 (February 1988): 49???52. http://dx.doi.org/10.1097/00004703-198802000-00011.

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45

Burns, Jeffrey, and John H. Arnold. "Pediatric critical care." Current Opinion in Pediatrics 6, no. 3 (June 1994): 295–302. http://dx.doi.org/10.1097/00008480-199406000-00011.

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46

Kim, Min Sun. "Pediatric Palliative Care." Clinical Pediatric Hematology-Oncology 27, no. 1 (April 30, 2020): 55–60. http://dx.doi.org/10.15264/cpho.2020.27.1.55.

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47

Zelinskaya, D. I. "PEDIATRIC PALLIATIVE CARE." Rossiyskiy Vestnik Perinatologii i Pediatrii (Russian Bulletin of Perinatology and Pediatrics) 61, no. 6 (January 1, 2016): 7–12. http://dx.doi.org/10.21508/1027-4065-2016-61-6-7-12.

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48

Fromer, Margot J. "Pediatric Palliative Care." Oncology Times 26, no. 17 (September 2004): 26–29. http://dx.doi.org/10.1097/01.cot.0000292277.96386.e2.

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49

BAUMAN, LOREN A., and David E. Longnecker. "Pediatric Intensive Care." Anesthesiology 68, no. 5 (May 1988): 831. http://dx.doi.org/10.1097/00000542-198805000-00054.

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Larsson, B. A. "Pediatric Critical Care." British Journal of Anaesthesia 98, no. 3 (March 2007): 410. http://dx.doi.org/10.1093/bja/ael374.

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