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The goals of this project are to generate data regarding the association between specific diabetes treatment regimens and the risk of hypoglycemia among patients with Medicaid and to examine whether neighborhood characteristics modify the effect of treatment regimens in this patient population. This data will inform management strategies of patients with social risk factors and diabetes with the goal of improving diabetes outcomes among low-income patients in Delaware.
Principal Investigator: Jennifer N. Goldstein, MD, MSc, Program Director, Clinical Research Education, Christiana Care Health System. Co-Investigators: Katie Gifford, PhD, Policy Scientist, Mary Joan McDuffie, MA, Policy Scientist & Medicaid Research Program Director; Erin Nescott, MS, Policy Scientist.
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The World Health Organization (WHO) and the United Children's Fund (UNICEF) initiated the Baby Friendly Hospital Initiative to create positive environments to enhance breastfeeding attitudes and experiences for mothers and babies. Hospitals gain this designation by implementing the WHO Ten Steps to Successful Breastfeeding. While breastfeeding has been shown to positively impact infant health outcomes and becoming Baby Friendly is economically cost neutral, little evidence has shown the effect of Baby Friendly practices on early infant health outcomes. The goal of this research is to estimate healthcare utilization before and after the implementation of the Baby Friendly Hospital Initiative at hospitals in the state of Delaware.
Principal Investigator: David Paul, MD, Chair, Department of Pediatrics, Christiana Care Health System. Co-Investigators: Cecelia Harrison, MPH, Research Associate, Christiana Care Health System; Mia Papas, PhD MPH, Corporate Director, Christiana Care Health System. CCRS research team: Mary Joan McDuffie, MA, Policy Scientist & Medicaid Research Program Director; Erin Lynch, MS, Policy Scientist.
An ACCEL Orbit Award supports the enhancement of the Medicaid data analysis infrastructure to reduce barriers to researchers interested in working with the Medicaid data. In pursuit of this goal, the research team is working on the creation of an expanded data dictionary and a refined data structure. The research team is comprised of individuals from CCRS, Christiana Care Health Systems (CCHS), and DMMA. Work supported by an Institutional Development Award (IDeA) from the National Institute of General Medical Sciences of the National Institutes of Health under grant number U54-GM104941 (PI: Binder-Macleod)
CCRS Research team:
Erin K. Knight, PhD, MPH, Associate Director and Assistant Professor
Mary Joan McDuffie, MA, Policy Scientist and Medicaid Research Program Director
Katie Gifford, PhD, Policy Scientist
Nemours Children Health System launched an asthma intervention program titled, "Optimizing Health Outcomes for Children with Asthma in Delaware" on July 1, 2012 with funding from a Centers for Medicare & Medicaid Services Innovation (CMMI) Award. In December 2014, Nemours engaged the services of the University of Delaware, Center for Community Research and Service, to conduct an analysis of the health services utilization among children enrolled in Medicaid that are served by the Nemours health system in order to help evaluate the asthma intervention. The analysis was meant to help answer two major questions related to the initial goals of the project: (1) Compared to a period before services were provided, has the frequency of serious asthma-related health incidents (defined as emergency department visits and hospitalizations) decreased? (2) Has the total cost of these services decreased? In investigating these questions, data on asthma-related health incidents, healthcare service utilization and healthcare costs extracted from the Delaware Medicaid claims data and linked with Nemours asthma home health care visit data were analyzed pre- and post, geographically and by demographic characteristics.
The Delaware General Assembly established the Delaware Task Force on the Health of Children in Foster Care in 2014 with the assignment of examining health services for children in the Delaware foster care system. CCRS supported the work of the task force by analyzing the Delaware Medicaid claims to compare health care utilization patterns of children in foster care with other children in Medicaid. Data from the Delaware Division of Family Services was linked with the Medicaid claims data in order to identify the children in foster care along with variables of time in system and type of foster care. See the Foster Care reports and publications in our Recent Publications section.
A retrospective cohort mortality study of mental health clients enrolled in Delaware Medicaid as of January 1, 2011was conducted for deaths occurring between January 1, 2011 through December 31, 2013. The primary investigator for this project was Dr. Mia Papas from the College of Health Sciences. Associations with medical care utilization and premature mortality were analyzed by fitting logistic regression models. Mental health clients were identified from a data set from the Delaware Division of Substance Abuse and Mental Health (DSAMH). Death data was provided by the Delaware Division of Public Health (DPH). CCRS linked the DSAMH and DPH data with the Delaware Medicaid claims in order to assess the health care utilization.
Through the Center for Disease Control (CDC), working with the primary investigator - Center for Disabilities Studies (CDS) at the University of Delaware CCRS provided profiles of Medicaid health utilization comparing individuals with disabilities to the remaining population. In addition, CCRS analyzed the Behavioral Risk Factor Surveillance System (BRFSS) for Delaware to measure health indicators (for example, cancer screenings) between the two populations. See: