Child Health Services Research and Epidemiology
Center Leaders: Louis Bell, MD and Jeffrey H. Silber, MD, PhD
Despite remarkable advances in biomedical research and the treatment of disease, evidence exists that the complex systems of pediatric healthcare and other child-oriented services do not perform well, resulting in poor outcomes for child health while incurring high costs. It is critical that investigators understand this performance gap to learn how to close it and provide good health outcomes for all children.
Racial and socioeconomic disparities in child health continue to be well documented. To add to the problem, therapies and interventions known to be effective – like medications to control asthma attacks – are generally underutilized. These problems – and many others – adversely impact the health of children.
The Child Health Services Research and Epidemiology Research Affinity Group studies the cause and distribution of disease and quality of health in children. It also aims to improve children’s health and well-being by analyzing the causes and distribution of disease, quality of health and child-oriented services.
Because these outcomes are influenced by a multitude of factors, research affinity group research typically involves many disciplines including economics, psychology, biostatistics and medicine. For example, researchers in the affinity group develop and apply methods from their respective disciplines to improve the quality of the research in pediatric health services research. They also use multivariate matching techniques and apply econometric modeling to claims data, surveys and administrative databases.
Wishing to understand which therapies are most effective has lead to the launch of the Center for Pediatric Clinical Effectiveness (CPCE). Developed as a new Center of Emphasis closely aligned with the affinity group, the mission of CPCE is to discover and disseminate knowledge about best practices in the management of pediatric disease. CPCE will provide infrastructure for training in and performance of clinical effectiveness research - research aimed at understanding the best ways to prevent, diagnose and treat diseases in children.
Another valuable resource for the affinity group, the Center for Outcomes Research focuses on developing new methodologies in health services that may significantly impact the health of children.
Examples of the affinity group’s work include projects aimed at understanding the organization of behavioral healthcare for children with attention deficit and hyperactivity disorder, improving the long-term care of children with asthma, improving screening and early recognition of childhood autism, and identifying the best strategies for preventing poor outcomes in common pediatric diseases.
Affinity group investigators also examine variations in the quality of care premature infants receive and the resultant outcomes, the impact of maternal obesity on neonatal outcomes, optimal discharge time of premature infants from neonatal intensive care unit and the impact of medication errors in the pediatric intensive care unit.
In addition, investigators focus on understanding the impact of peer influences that lead teenagers to risky behaviors, the impact on healthcare access for underserved children and families, racial disparities in outcomes, and the difference in outcomes of similar patients across different types of healthcare providers. Members of the affinity group have also explored methods to reduce surgical post-operative mortality rates and analyzed the influence of obesity on surgical outcomes.