Children's Health Care

"Congressionally Mandated Evaluation of the State Children's Health Insurance Program: Final Report to Congress." Judith Wooldridge, Genevieve Kenney, and Christopher Trenholm, with Lisa Dubay, Ian Hill, Myoung Kim, Lorenzo Moreno, Anna Sommers, and Stephen Zuckerman, October 2005. Across the country, children without health insurance are a cause for concern. This report examines the design and implementation of State Children's Health Insurance Programs, noting that they were succeeding in almost all areas examined. The study focused on 10 states with a large proportion of eligible and enrolled children nationwide, developing findings from surveys of enrolled and recently disenrolled children in these states. The study incorporated a national perspective, drawing on a national survey of state program administrators, as well as a national survey of low-income uninsured children.
Executive summary. Full report. Read more about the study.

Postambulatory Care

"Factors Influencing Patient Disposition After Ambulatory Herniorrhaphy." S. Memtsoudis, M. Besculides, and C. Swamidoss, Journal of Ambulatory Surgery, November 2005. This study examined factors associated with patients' discharge to a facility other than their home after elective, ambulatory inguinal hernia repair. These factors included anesthesia type, anesthesia provider, increasing age of the patient, and bi- versus unilaterality of the procedure. Differences were also found by facility type and region in which the procedure was performed. The increased cost associated with a discharge to a facility other than home requires identification of factors that independently contribute to such an outcome. This study identified a number of anesthesia-related and other factors that may affect patients' discharge options.

Developing the Next Generation

"The Effectiveness of Early Head Start for 3-Year-Old Children and Their Parents: Lessons for Policy and Programs." John M. Love, Ellen Eliason Kisker, Christine Ross, Helen Raikes, Jill Constantine, Kimberly Boller, Jeanne Brooks Gunn, Rachel Chazan-Cohen, Louisa Banks Tarullo, Peter Z. Schochet, Christy Brady-Smith, Allison Sidle Fuligni, Diane Paulsell, and Cheri Vogel, Developmental Psychology, 2005. Early Head Start, a federal program begun in 1995 for low-income pregnant women and families with infants and toddlers, was evaluated through a randomized trial of 3,001 families in 17 programs. Interviews with primary caregivers, child assessments, and observations of parent-child interactions were completed when children were three years old. Caregivers were diverse in race-ethnicity, language, and other characteristics. The program children performed better than control children in cognitive and language development, displayed higher emotional engagement of the parent and sustained attention with play objects, and were lower in aggressive behavior. Compared with controls, EHS parents were more emotionally supportive, provided more language and learning stimulation, read to their children more, and spanked less. The strongest and most numerous impacts were for programs that offered a mix of home-visiting and center-based services and fully implemented the performance standards early.

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