Evaline A. Alessandrini

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OBJECTIVE The goal was to assess the impact of influenza vaccine clinical alerts on missed opportunities for vaccination and on overall influenza immunization rates for children and adolescents with asthma. METHODS A prospective, cluster-randomized trial of 20 primary care sites was conducted between October 1, 2006, and March 31, 2007. At intervention(More)
OBJECTIVE To evaluate selected characteristics of occult bacteremia in the post-Haemophilus influenzae type b (HIB) vaccine era. METHODS A retrospective cohort study was performed involving 5901 children 2 to 24 months old with fever >/=39.0 degrees C evaluated with a blood culture at an urban tertiary care children's hospital emergency department (ED)(More)
OBJECTIVES To identify patterns of shared decision-making (SDM) among a nationally representative sample of US children with attention-deficit/hyperactivity disorder (ADHD) or asthma and determine if demographics, health status, or access to care are associated with SDM. PATIENTS AND METHODS We performed a cross-sectional study of the 2002-2006 Medical(More)
OBJECTIVES To determine the incidence of return visits (RVs), types of RVs, and factors associated with RVs to a pediatric emergency department (ED). METHODS : Retrospective cohort study of patients seen in an urban, tertiary care pediatric ED. MAIN OUTCOME RV within 48 hours, identified from a computerized log. RESULTS The total RV rate was 3.5% (95%(More)
OBJECTIVE Unscheduled revisits (URVs) may serve as markers of quality of care and may be costly both in financial terms as well as in limitations they place on primary care. We performed this study to examine the association between characteristics easily obtainable during an emergency department (ED) visit and URV to identify a subpopulation of children(More)
BACKGROUND Diagnosis information from existing data sources is used commonly for epidemiologic, administrative, and research purposes. The quality of such data for emergency department (ED) visits is unknown. OBJECTIVES To determine the agreement on final diagnoses between two sources, electronic administrative sources and manually abstracted medical(More)
OBJECTIVE An opportunity exists to use increasingly prevalent electronic health records to efficiently gather immunization, clinical, and demographic data to assess and subsequently reduce barriers to immunization. The objective of this study was to use data entered at the point of care within an electronic health record to identify factors that predispose(More)
BACKGROUND AND OBJECTIVES To understand the association between shared decision-making (SDM) and health care expenditures and use among children with special health care needs (CSHCN). METHODS We identified CSHCN <18 years in the 2002-2006 Medical Expenditure Panel Survey by using the CSHCN Screener. Outcomes included health care expenditures (total,(More)
OBJECTIVE Each day, children incur more than 69,000 emergency department (ED) visits, with 58% to 82% of them for nonurgent reasons. The objectives of this study were to elicit and to describe guardians' and health professionals' opinions on reasons for nonurgent pediatric ED visits. METHODS Focus groups sessions were held with 3 groups of guardians, 2(More)
BACKGROUND Blood, urine, and cerebrospinal fluid cultures and admission for antibiotics are considered standard management of febrile neonates (0-28 days). We examined variation in adherence to these recommendations across US pediatric emergency departments (PEDs) and incidence of serious infections (SIs) in febrile neonates. METHODS Cross-sectional study(More)