After the recent economic recession, policy interventions including austerity measures led to reductions in government spending on health care in many countries. However, there is limited research into the effects of changes in government health care spending on child health.

Reductions in government health care spending are associated with long-lasting adverse effects on child health globally, especially in low-income countries. Given pressures to diminish health expenditures, we caution that reduced spending should be achieved through increased efficiency of care delivery. (Read the full article)

Children with special health care needs are a growing population in developed countries. They are at risk for poorer learning and behavioral outcomes, and their parents are more likely to have poorer mental health.

Four distinct and replicable special health care need profiles across 2 childhood epochs were categorized as none, transient, emerging, and persistent. The cumulative burden of special health care needs shaped adverse outcomes more than did point prevalence. (Read the full article)

Care coordination is a central part of the medical home model. Little is known about how care coordination is implemented in pediatrics and how it changes over time in primary care practices successfully adopting medical home principles.

In high-performing medical homes, care coordination evolved toward designing and carrying out routine activities and policies that aimed to forestall disruptions in care delivery. Investing in medical home teams, engaging electronic medical record systems, and improving workflow supported these changes. (Read the full article)

US parents trust the health care system and bring their infant children in for preventive care. Previous studies have demonstrated the ability of health care systems to identify, and sometimes address, the economic needs of low-income families.

Families of newborns at a safety-net primary care center have high levels of economic hardship. Compared with controls, Developmental Understanding and Legal Collaboration for Everyone families had accelerated access to concrete supports, improved rates of on-time immunization and preventive care, and decreased emergency department utilization. (Read the full article)

More than 200 million children <5 years are not reaching their developmental potential. Lack of stimulating caregiving is a major cause, and effective scalable interventions are needed. Integrating parenting with health services has been recommended, but there are few evaluations.

An innovative parenting intervention can be delivered at routine visits for primary health care, with benefits to child cognitive development and parenting knowledge. This approach using films, discussion, and practice has the potential for delivery at scale. (Read the full article)

Unmet health care need in adolescence is associated with poor contemporaneous health outcomes. Adolescence is increasingly recognized as an important stage of the life-course, when there may be a significant opportunity for health care interventions to improve later health outcomes.

The odds of adverse adult health outcomes were 13% to 52% higher among subjects who had reported unmet health care need in adolescence, compared with subjects with similar adolescent health outcomes, insurance coverage, and sociodemographic background but no unmet need. (Read the full article)

Children with medical complexity require a disproportionate amount of health services due to a multitude of chronic severe illness, and their impact on the health care system appears to be increasing.

This study provides one of the first comparisons of health care utilization patterns for children with medical complexity between medical centers in a population-based cohort. (Read the full article)

Paul W. Newacheck
Jul 1, 1998; 102:117-123
ARTICLES

Merle McPherson
Jul 1, 1998; 102:137-139
COMMENTARY

Penn State Health St. Joseph has moved swiftly to tackle the COVID-19 crisis, converting portions of its hospital as COVID-19 clinics, applying tried-and-true methods and learning on the fly.

The Penn State Wilkes-Barre Alumni Society provided lunch for local, hardworking medical professionals as a way to thank them for their efforts during the ongoing coronavirus outbreak and working to keep local residents safe.

Delaware’s Department of Insurance is pleased to announce that it is actively recruiting for a qualified independent contractor to staff and run its new Office of Value-Based Health Care Delivery. The Office will assist the Insurance Commissioner and Delaware’s Primary Care Reform Collaborative in evaluating primary care accessibility and affordability statewide. “Reducing health care costs […]

NEW CASTLE (May 3, 2018) – Ranking in the bottom half of states in a variety of health measures, including adults who smoke, annual diabetes treatment testing, and adults who are obese, Delaware fell four spots in The Commonwealth Fund’s 2018 Scorecard on State Health System Performance released today. Delaware ranked 22nd among all the […]

Op-ed by Rick Geisenberger, Secretary of the Delaware Department of Finance Over the next several weeks, as we complete another budget debate in Dover, we should not lose sight of Delaware’s long-term challenges and of one issue in particular: the rising cost of health care. The projected growth rate for state spending on health care […]

NEW CASTLE (May 30, 2018) – As a way to better support the needs of children with medical complexity and their families, the Division of Medicaid and Medical Assistance this week released Delaware’s Plan for Managing the Health Care Needs of Children with Medical Complexity and announced that stakeholders will continue work to develop longer-term […]

WILMINGTON, Del. – In support of a movement to transform how health care is delivered and paid for in the state, Delaware was one of eight states chosen to participate in a National Governors Association initiative to harness data systems to inform health policymaking. Joining Arkansas, Colorado, Indiana, Iowa, Minnesota, Vermont and Washington, Delaware’s team […]

NEW CASTLE (July 26, 2018) – As part of the State Innovation Model (SIM) initiative, the Delaware Health Care Commission is seeking applications from Delaware health care providers for one-time, value-based payment reform mini-grants to grow their capacity to integrate data, improve the coordination of patient care or increase their readiness to integrate into a […]

NEW CASTLE (Nov. 15, 2018) – As part of the State Innovation Model (SIM) initiative, the Delaware Health Care Commission has awarded the first value-based payment reform mini-grant to Christiana Care Health System to test a new reimbursement model that will also improve the coordination of patient care. Christiana Care Health System’s CareLink Behavioral Health […]

Order will create subcommittee focused on bettering health care spending, quality across the state WILMINGTON, Del. – Governor Carney on Tuesday signed Executive Order #25 establishing health care spending and quality benchmarks. This Executive Order will form a subcommittee of the Delaware Economic and Financial Advisory Council to focus on reducing the cost of health […]

NEW CASTLE (Dec. 4, 2018) – As part of the State Innovation Model (SIM) initiative, the Delaware Health Care Commission has awarded eight additional value-based payment reform mini-grants to Delaware health care providers in order to facilitate data integration, improve the coordination of patient care or increase readiness to integrate into an Accountable Care Organization […]

Benchmark initiative will limit spending growth, improve quality of care NEW CASTLE, Del. – The Delaware Economic and Financial Advisory Council (DEFAC) on Wednesday issued a recommended Benchmark Index that set the state’s health care spending growth target at 3.8 percent for 2019 – the initial year of Delaware’s newly created Health Care Spending Benchmark. […]

NEW CASTLE (Sept. 3, 2019) – Department of Health and Social Services (DHSS) Secretary Dr. Kara Walker announced the appointment of Yrene Waldron, former Executive Director of the Delaware Health Care Facilities Association, to lead the Division of Health Care Quality. She will begin her duties Sept. 16. “I am thrilled that Yrene is joining […]

DOVER, Del. – Governor John Carney, along with the Delaware Department of Health and Social Services (DHSS), announced on Friday a coordinated statewide plan to ensure individuals with symptoms consistent with coronavirus disease 2019 (COVID-19) have access to safe and efficient testing in Delaware. Tests will be administered at no cost to the patients. Through […]

Community call-to-action issued for workforce support WILMINGTON, Del. – Governor John Carney expanded his community call-to-action on Saturday morning, urging all Delaware citizens with health care and child care experience to offer their expertise in Delaware’s fight against COVID-19. Last week, Governor Carney urged citizens, businesses and nonprofits with access to emergency materials and supplies […]

Twelfth modification allows the Public Health Authority to activate additional workers WILMINGTON, Del. – Governor John Carney on Thursday issued the twelfth modification to his State of Emergency declaration, which will allow the Public Health Authority to activate more out-of-state health care workers to assist in Delaware’s fight against COVID-19.        Read Governor Carney’s updated State […]

Denmark, being a tiny country, is into managing well enough for the countrymen regarding the aspect of health care. The government of the country is engaged in providing cradle-to-grave health care policies. At the same time, the policies for the students…

The coronavirus crisis has exposed grave vulnerabilities in the nation's medical services.

The Covid-19 crisis has exposed weaknesses in Chinese health care system despite some impressive reforms over the past two decades, witnesses told an advisory arm of the US Congress on Thursday.China has strengthened its Centre for Disease Control and Prevention (CDC) to improve the monitoring of outbreaks and better coordinate local public health authorities, US experts on international health care told the United States-China Economic and Security Review Commission.This happened after the…

Universal health coverage must be high quality to improve patients’ health outcomes

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The conversation about how we create and maintain health has evolved. We have now clearly expanded our thinking beyond an exclusive focus on traditional medical care, and philanthropy can play an important role

With rising costs and below-average outcomes, North Carolina's health care value proposition is upside down. It's time for employers to lead transformative change.

North Carolina has received national attention for its approach to health care payment and delivery reform. Importantly, payment reform alone is not enough to drive systematic changes in care delivery. We highlight the importance of progress in four complementary areas to achieve system-wide payment and care reform.

Place—a confluence of the social, economic, political, physical, and built environments—is fundamental to our understanding of health and health inequities among marginalized racial groups in the United States. Moreover, racism, defined as a system of structuring opportunity and assigning value based on the social interpretation of how one looks (i.e., race), has shaped the places people live in North Carolina. This problem is deeply imbedded in all of our systems, from housing to health care, affecting the ability of every resident of the state to flourish and thrive.

In 2019, the National Academy of Medicine (NAM) turned to the all-important state level to draw insights on the status of health and health care within the context of the NAM Vital Directions for Health and Health Care initiative. The NAM held a two-day symposium in the Research Triangle to bring together various stakeholders to better understand actions that states and localities are taking to achieve—and the barriers they face in pursuing—more affordable, value-driven quality care and health outcomes. The NAM purposefully chose to pivot to the state level with North Carolina given that it has been at the forefront of health care transformation and illustrates the promise but also the challenges facing US health and health care nationally. A 19-member planning committee, cochaired by NAM President Victor Dzau and Secretary Mandy Cohen of the North Carolina Department of Health and Human Services, selected topics that resonate with the state's activities within the context of the Vital Directions framework, ranging from empowering people and connecting care through the integration of social, physical, and behavioral health to payer alignment though the advancement of new payment models (Figure 1). The priorities discussed during the symposium continue to be central to health reform in North Carolina and are further explored in the commentaries in this issue.

Pediatricians are encouraged to address male adolescent sexual and reproductive health on a regular basis, including taking a sexual history, discussing healthy sexuality, performing an appropriate physical examination, providing patient-centered and age-appropriate anticipatory guidance, and administering appropriate vaccinations. These services can be provided to male adolescent patients in a confidential and culturally appropriate manner, can promote healthy sexual relationships and responsibility, can and involve parents in age-appropriate discussions about sexual health.

Purpose:

To identify specific actions and characteristics of health care providers (HCPs) in the United States and Canada that influenced patients with type 2 diabetes who were initially reluctant to begin insulin.

Access to services related to reproductive and sexual health is critical to the health of women but has been threatened in recent years. Family physicians are trained to provide a range of women’s health care services and are an essential part of the health care workforce in rural and underserved areas, where access to these services may be limited.

OBJECTIVE

With rising health care costs and finite health care resources, understanding the population needs of different type 2 diabetes mellitus (T2DM) patient subgroups is important. Sparse data exist for the application of population segmentation on health care needs among Asian T2DM patients. We aimed to segment T2DM patients into distinct classes and evaluate their differential health care use, diabetes-related complications, and mortality patterns.

Background:

First Nations people in Ontario have an increased prevalence of diabetes compared to other people in the province. This study examined use of health care services by First Nations people with diabetes and other people with diabetes in Ontario.

Mike Bloomberg is agreeing to pay for health care through November for the more than 2,000 campaign staffers he laid off after suspending his presidential bid as he faces public pressure and multiple lawsuits.