wow-inequalities/02-data/intermediate/wos_sample/851fc8a16c1070c98ed6760b12b04d2f-henrickson-michael/info.yaml

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2023-09-28 14:46:10 +00:00
abstract: 'The United States pediatric population with chronic health conditions is
expanding. Currently, this demographic comprises 12-18\% of the American
child and youth population. Affected children often receive fragmented,
uncoordinated care. Overall, the American health care delivery system
produces modest outcomes for this population. Poor, uninsured and
minority children may be at increased risk for inferior coordination of
services. Further, the United States health care delivery system is
primarily organized for the diagnosis and treatment of acute conditions.
For pediatric patients with chronic health conditions, the typical acute
problem-oriented visit actually serves as a barrier to care. The
biomedical model of patient education prevails, characterized by
unilateral transfer of medical information. However, the evidence basis
for improvement in disease outcomes supports the use of the chronic care
model, initially proposed by Dr. Edward Wagner. Six inter-related
elements distinguish the success of the chronic care model, which
include self-management support and care coordination by a prepared,
proactive team.
United States health care lacks a coherent policy direction for the
management of high cost chronic conditions, including rheumatic
diseases. A fundamental restructure of United States health care
delivery must urgently occur which places the patient at the center of
care. For the pediatric rheumatology workforce, reimbursement policies
and the actions of health plans and insurers are consistent barriers to
chronic disease improvement. United States reimbursement policy and
overall fragmentation of health care services pose specific challenges
for widespread implementation of the chronic care model. Team-based
multidisciplinary care, care coordination and self-management are
integral to improve outcomes.
Pediatric rheumatology demand in the United States far exceeds available
workforce supply. This article reviews the career choice decision-making
process at each medical trainee level to determine best recruitment
strategies. Educational debt is an unexpectedly minor determinant for
pediatric residents and subspecialty fellows. A two-year fellowship
training option may retain the mandatory scholarship component and
attract an increasing number of candidate trainees. Diversity, work-life
balance, scheduling flexibility to accommodate part-time employment, and
reform of conditions for academic promotion all need to be addressed to
ensure future growth of the pediatric rheumatology workforce.'
affiliation: 'Henrickson, M (Corresponding Author), Cincinnati Childrens Hosp, Med
Ctr, Div Rheumatol, MLC 4010,3333 Burnet Ave, Cincinnati, OH 45229 USA.
Cincinnati Childrens Hosp, Med Ctr, Div Rheumatol, Cincinnati, OH 45229 USA.'
article-number: '24'
author: Henrickson, Michael
author-email: michael.henrickson@cchmc.org
author_list:
- family: Henrickson
given: Michael
da: '2023-09-28'
doi: 10.1186/1546-0096-9-23
eissn: 1546-0096
files: []
journal: PEDIATRIC RHEUMATOLOGY
keywords: pediatric rheumatology; pediatric subspecialty; policy; workforce
keywords-plus: 'CONTROLLABLE LIFE-STYLE; CHRONIC ILLNESS CARE; SPECIALTY CHOICE;
SUBSPECIALTY WORKFORCE; FELLOWS PERSPECTIVES; MEDICAL-STUDENTS; FUTURE
SCOPE; CHILDREN; MODEL; MANAGEMENT'
language: English
month: AUG 16
number-of-cited-references: '80'
papis_id: de5e899756fe6a6679cbb00d497656dc
ref: Henrickson2011policychallenges
researcherid-numbers: Henrickson, Michael/AAE-8221-2022
tags:
- review
times-cited: '21'
title: 'Policy challenges for the pediatric rheumatology workforce: Part II. Health
care system delivery and workforce supply'
2023-10-01 08:15:07 +00:00
type: article
2023-09-28 14:46:10 +00:00
unique-id: WOS:000294857600001
usage-count-last-180-days: '1'
usage-count-since-2013: '8'
volume: '9'
web-of-science-categories: Pediatrics; Rheumatology
year: '2011'