Evidence map›Paper›PMID 37461185›Full record

ArticleHealth services research2024

Specialist use among privately insured children with disabilities.

Alyna T Chien, Lauren E Wisk, Nancy Beaulieu, Amy J Houtrow, Jeanne Van Cleave, Christina Fu, David Cutler, Mary Beth Landrum

Abstract read
In one paragraph

Article in Health services research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Financing the "Village": Establishing a Sustainable Financial System for Child Behavioral Health.Child and adolescent psychiatric clinics of North America · 2024
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Alyna T ChienDivision of General Pediatrics, Department of General Pediatrics, Boston Children's Hospital, Boston, Massachusetts, USA.ORCID 0000-0002-9302-8015
Lauren E WiskDivision of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California, USA.
Nancy BeaulieuDepartment of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA.ORCID 0000-0003-2388-1376
Amy J HoutrowDepartment of Physical Medicine and Rehabilitation, University of Pittsburgh School of Medicine, University of Pittsburgh Medical Center Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Jeanne Van CleaveDepartment of Pediatrics, University of Colorado School of Medicine, Anshutz Medical Campus, Children's Hospital Colorado, Aurora, Colorado, USA.
Christina FuDepartment of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA.
David CutlerDepartment of Economics, Harvard University, National Bureau of Economic Research, Cambridge, Massachusetts, USA.
Mary Beth LandrumDepartment of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA.

Funding

PA-20-072: Accelerating the Use of Evidence-based Innovation in Healthcare SystemsU19HS024075 · AHRQ · DARTMOUTH COLLEGE · PI MEARA, ELLEN R. · 2015 to 2021
$19.8M
Delivering contextualizing population data to patients to motivate health care transition preparationK01DK116932 · NIDDK · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI WISK, LAUREN ELISABETH · 2018 to 2023
$647k
Agency for Healthcare Research and Quality U19 HS024075-05AHRQ HHS U19 HS024075NIDDK NIH HHS K01 DK116932
6 · The paper itself

Abstract

objectiveTo investigate primary care practice ownership and specialist-use patterns for commercially insured children with disabilities. DATA SOURCES AND STUDY

settingA national commercial claims database and the Health Systems and Provider Database from 2012 to 2016 are the data sources for this study. STUDY

designThis cross-sectional, descriptive study examines: (1) the most visited type of pediatric primary care physician and practice (independent or system-owned); (2) pediatric and non-pediatric specialist-use patterns; and (3) how practice ownership relates to specialist-use patterns. DATA COLLECTION/EXTRACTION

methodsThis study identifies 133,749 person-years of commercially insured children with disabilities aged 0-18 years with at least 24 months of continuous insurance coverage by linking a national commercial claims data set with the Health Systems and Provider Database and applying the validated Children with Disabilities Algorithm. PRINCIPAL

findingsThree-quarters (75.9%) of children with disabilities received their pediatric primary care in independent practices. Nearly two thirds (59.6%) used at least one specialist with 45.1% using nonpediatric specialists, 28.8% using pediatric ones, and 17.0% using both. Specialist-use patterns varied by both child age and specialist type. Children with disabilities in independent practices were as likely to see a specialist as those in system-owned ones: 57.1% (95% confidence interval [95% CI] 56.7%-57.4%) versus 57.3% (95% CI 56.6%-58.0%), respectively (p = 0.635). The percent using two or more types of specialists was 46.1% (95% CI 45.4%-46.7%) in independent practices, comparable to that in systems 47.1% (95% CI 46.2%-48.0%) (p = 0.054). However, the mean number of specialist visits was significantly lower in independent practices than in systems-4.0 (95% CI 3.9%-4.0%) versus 4.4 (95% CI 4.3%-4.6%) respectively-reaching statistical significance with p < 0.0001.

conclusionsRecognizing how privately insured children with disabilities use pediatric primary care from pediatric and nonpediatric primary care specialists through both independent and system-owned practices is important for improving care quality and value.

Indexed as

Children with DisabilitiesPrimary Health CareSpecializationAdolescentChildChild, PreschoolCross-Sectional StudiesFemaleHumansInfantInfant, NewbornInsurance, HealthMaleUnited Statesdisabilityhealth care organizations and systemsprimary care

Identifiers

PMID37461185
PMCPMC11250397

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.