{"database":"biostudies-literature","file_versions":[],"scores":null,"additional":{"submitter":["Chien AT"],"funding":["Agency for Healthcare Research and Quality","NIDDK NIH HHS","AHRQ HHS"],"pagination":["e14199"],"full_dataset_link":["https://www.ebi.ac.uk/biostudies/studies/S-EPMC11250397"],"repository":["biostudies-literature"],"omics_type":["Unknown"],"volume":["59(4)"],"pubmed_abstract":["<h4>Objective</h4>To investigate primary care practice ownership and specialist-use patterns for commercially insured children with disabilities.<h4>Data sources and study setting</h4>A national commercial claims database and the Health Systems and Provider Database from 2012 to 2016 are the data sources for this study.<h4>Study design</h4>This cross-sectional, descriptive study examines: (1) the most visited type of pediatric primary care physician and practice (independent or system-owned); (2) pediatric and non-pediatric specialist-use patterns; and (3) how practice ownership relates to specialist-use patterns.<h4>Data collection/extraction methods</h4>This study identifies 133,749 person-years of commercially insured children with disabilities aged 0-18 years with at least 24 months of continuous insurance coverage by linking a national commercial claims data set with the Health Systems and Provider Database and applying the validated Children with Disabilities Algorithm.<h4>Principal findings</h4>Three-quarters (75.9%) of children with disabilities received their pediatric primary care in independent practices. Nearly two thirds (59.6%) used at least one specialist with 45.1% using nonpediatric specialists, 28.8% using pediatric ones, and 17.0% using both. Specialist-use patterns varied by both child age and specialist type. Children with disabilities in independent practices were as likely to see a specialist as those in system-owned ones: 57.1% (95% confidence interval [95% CI] 56.7%-57.4%) versus 57.3% (95% CI 56.6%-58.0%), respectively (p = 0.635). The percent using two or more types of specialists was 46.1% (95% CI 45.4%-46.7%) in independent practices, comparable to that in systems 47.1% (95% CI 46.2%-48.0%) (p = 0.054). However, the mean number of specialist visits was significantly lower in independent practices than in systems-4.0 (95% CI 3.9%-4.0%) versus 4.4 (95% CI 4.3%-4.6%) respectively-reaching statistical significance with p < 0.0001.<h4>Conclusions</h4>Recognizing how privately insured children with disabilities use pediatric primary care from pediatric and nonpediatric primary care specialists through both independent and system-owned practices is important for improving care quality and value."],"journal":["Health services research"],"pubmed_title":["Specialist use among privately insured children with disabilities."],"pmcid":["PMC11250397"],"funding_grant_id":["U19 HS024075-05","K01 DK116932","U19 HS024075","U19 HS024075‐05"],"pubmed_authors":["Cutler D","Landrum MB","Van Cleave J","Chien AT","Fu C","Beaulieu N","Houtrow AJ","Wisk LE"],"additional_accession":[]},"is_claimable":false,"name":"Specialist use among privately insured children with disabilities.","description":"<h4>Objective</h4>To investigate primary care practice ownership and specialist-use patterns for commercially insured children with disabilities.<h4>Data sources and study setting</h4>A national commercial claims database and the Health Systems and Provider Database from 2012 to 2016 are the data sources for this study.<h4>Study design</h4>This cross-sectional, descriptive study examines: (1) the most visited type of pediatric primary care physician and practice (independent or system-owned); (2) pediatric and non-pediatric specialist-use patterns; and (3) how practice ownership relates to specialist-use patterns.<h4>Data collection/extraction methods</h4>This study identifies 133,749 person-years of commercially insured children with disabilities aged 0-18 years with at least 24 months of continuous insurance coverage by linking a national commercial claims data set with the Health Systems and Provider Database and applying the validated Children with Disabilities Algorithm.<h4>Principal findings</h4>Three-quarters (75.9%) of children with disabilities received their pediatric primary care in independent practices. Nearly two thirds (59.6%) used at least one specialist with 45.1% using nonpediatric specialists, 28.8% using pediatric ones, and 17.0% using both. Specialist-use patterns varied by both child age and specialist type. Children with disabilities in independent practices were as likely to see a specialist as those in system-owned ones: 57.1% (95% confidence interval [95% CI] 56.7%-57.4%) versus 57.3% (95% CI 56.6%-58.0%), respectively (p = 0.635). The percent using two or more types of specialists was 46.1% (95% CI 45.4%-46.7%) in independent practices, comparable to that in systems 47.1% (95% CI 46.2%-48.0%) (p = 0.054). However, the mean number of specialist visits was significantly lower in independent practices than in systems-4.0 (95% CI 3.9%-4.0%) versus 4.4 (95% CI 4.3%-4.6%) respectively-reaching statistical significance with p < 0.0001.<h4>Conclusions</h4>Recognizing how privately insured children with disabilities use pediatric primary care from pediatric and nonpediatric primary care specialists through both independent and system-owned practices is important for improving care quality and value.","dates":{"release":"2024-01-01T00:00:00Z","publication":"2024 Aug","modification":"2026-03-17T15:29:41.612Z","creation":"2025-08-16T03:06:57.913Z"},"accession":"S-EPMC11250397","cross_references":{"pubmed":["37461185"],"doi":["10.1111/1475-6773.14199"]}}