Medicaid MCO's and Suboptimal Pediatric Care

描述（由申请人提供）：候选人是一名儿科医生，致力于改善儿童医疗保健结果的公平性，特别是对于参加医疗补助的低收入儿童。奖励期间的职业发展活动产生于三个主要目标：1）成为最先进的儿童健康服务研究人员; 2）建立儿童健康服务研究中心;以及，3）提高国家对儿童健康服务研究的知名度。职业发展计划以成人学习理论为基础，为每一个目标设计和实施具体目标。实现每个目标的计划包括正式的指导，与合作者的互动，实际应用，自我评估和反馈。内部和外部高级教师的咨询小组将与候选人每半年举行一次会议，就实现既定目标和目的的进展提供反馈和指导。候选人的研究提案的目的是检查医疗补助管理的护理组织（MCO）对哮喘儿童获得特定推荐护理的影响，因为单个MCO可能会对授权护理或提供护理资源产生冲突的激励。该研究将比较华盛顿州和田纳西州约24，000名中度至重度哮喘儿童中MCO与哮喘预防药物的次优使用。这项研究将使用医疗补助研究数据库进行，该数据库与华盛顿州和田纳西州的重要记录和美国人口普查数据相关联。其他研究将采用新的研究方法，并将通过解决拟议研究的公认局限性来扩大研究结果。这些评价将增进对儿童照料不平等现象的了解，并使今后能够采取干预措施，减少弱势儿童的不平等现象。

DESCRIPTION (provided by the applicant): The candidate is a pediatrician committed to improving equity in childhood healthcare outcomes, especially for low-income children enrolled in Medicaid. Career development activities for the award period arise from three primary goals: 1) become a state-of-the-art child health services researcher; 2) establish a child health services research center; and, 3) increase national visibility for child health services research in high-risk, vulnerable children. The career development plan uses adult learning theory as a basis for designing and implementing specific objectives for each goal. Plans for achieving each objective include formal instruction, interaction with collaborators, practical applications, and self-evaluation and feedback. An advisory group of internal and external senior faculty will meet semi-annually with the candidate to provide feedback and guidance on progress towards stated goals and objectives. The aim of the candidate's research proposal is to examine the effect of Medicaid managed care organizations (MCOs) on access to specific recommended care for children with asthma, as individual MCOs may have conflicting incentives for authorizing care or providing resources for care. The study will compare MCO's with respect to suboptimal use of preventive medications for asthma among approximately 24,000 children with moderate to severe asthma in Washington State and Tennessee. The study will be conducted using a Medicaid research database, linked with vital records and U.S. Census data in Washington State and Tennessee. Additional studies will apply new research methodologies and will be directed at augmenting study findings by addressing recognized limitations of the proposed studies. These evaluations will increase understanding of inequities in care for children and will allow for future interventions to reduce disparities for vulnerable children.