Medical care
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For high-risk children with asthma enrolled in Medicaid, loss of Medicaid coverage is a potential threat to access to quality asthma care. ⋯ Children with asthma who had gaps in a Medicaid managed care insurance program had no increase in asthma related emergency department visits and hospitalizations. Children who had gaps did have fewer nonrespiratory emergency department visits and hospitalizations than their non-gap counterparts. Further study is needed to explore the reasons for this unexpected finding.
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The practice of ordering "Do-Not-Resuscitate" (DNR) varies across hospitals. No research has explored how the DNR variation would affect cross-institutional performance reporting when DNR status is used as a risk adjustor. ⋯ Using locally defined DNR as an additional covariate potentially introduces systematic bias in performance reporting. A more uniform definition and application of DNR is needed if it is to be included as a risk adjustor.