Health Services Research and Managerial Epidemiology最新文献

{"title":"Perceiving and Addressing the Pervasive Racial Disparity in Abortion.","authors":"James Studnicki,&nbsp;John W Fisher,&nbsp;James L Sherley","doi":"10.1177/2333392820949743","DOIUrl":"https://doi.org/10.1177/2333392820949743","url":null,"abstract":"<p><p>Black women have been experiencing induced abortions at a rate nearly 4 times that of White women for at least 3 decades, and likely much longer. The impact in years of potential life lost, given abortion's high incidence and racially skewed distribution, indicates that it is the most demographically consequential occurrence for the minority population. The science community has refused to engage on the subject and the popular media has essentially ignored it. In the current unfolding environment, there may be no better metric for the value of Black lives.</p>","PeriodicalId":12951,"journal":{"name":"Health Services Research and Managerial Epidemiology","volume":"7 ","pages":"2333392820949743"},"PeriodicalIF":1.6,"publicationDate":"2020-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2333392820949743","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38335266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pregnancy Outcome Patterns of Medicaid-Eligible Women, 1999-2014: A National Prospective Longitudinal Study.","authors":"James Studnicki,&nbsp;John W Fisher,&nbsp;David C Reardon,&nbsp;Christopher Craver,&nbsp;Tessa Longbons,&nbsp;Donna J Harrison","doi":"10.1177/2333392820941348","DOIUrl":"https://doi.org/10.1177/2333392820941348","url":null,"abstract":"<p><strong>Introduction: </strong>The number and outcomes of pregnancies experienced by a woman are consequential determinants of her health status. However, there is no published research comparing the patterns of subsequent pregnancy outcomes following a live birth, natural fetal loss, or induced abortion.</p><p><strong>Objectives: </strong>The objective of this study was to describe the characteristic patterns of subsequent pregnancy outcomes evolving from each of three initiating outcome events (birth, induced abortion, natural fetal loss) occurring in a Medicaid population fully insured for all reproductive health services.</p><p><strong>Methods: </strong>We identified 7,388,842 pregnancy outcomes occurring to Medicaid-eligible women in the 17 states which paid for abortion services between 1999-2014. The first known pregnancy outcome for each woman was marked as the index outcome which assigned each woman to one of three cohorts. All subsequent outcomes occurring up to the fifth known pregnancy were identified. Analyses of the three index outcome cohorts were conducted separately for all pregnancy outcomes, three age bands (<17, 17-35, 36+), and three race/ethnicity groups (Hispanic, Black, White).</p><p><strong>Results: </strong>Women with index abortions experienced more lifetime pregnancies than women with index births or natural fetal losses and were increasingly more likely to experience another pregnancy with each subsequent pregnancy. Women whose index pregnancy ended in abortion were also increasingly more likely to experience another abortion at each subsequent pregnancy. Both births and natural fetal losses were likely to result in a subsequent birth, rather than abortion. Women with natural losses were increasingly more likely to have a subsequent birth than women with an index birth. All age and racial/ethnic groups exhibited the characteristic pattern we have described for all pregnancy outcomes: abortion is associated with more subsequent pregnancies and abortions; births and fetal losses are associated with subsequent births. Other differences between groups are, however, apparent. Age is positively associated with the likelihood of a birth following an index birth, but negatively associated with the likelihood of a birth following an index abortion. Hispanic women are always more likely to have a birth and less likely to have an abortion than Black or White women, for all combinations of index outcome and the number of subsequent pregnancies. Similarly, Black women are always more likely to have an abortion and less likely to experience a birth than Hispanic or White women.</p><p><strong>Conclusion: </strong>Women experiencing repeated pregnancies and subsequent abortions following an index abortion are subjected to an increased exposure to hemorrhage and infection, the major causes of maternal mortality, and other adverse consequences resulting from multiple separation events.</p>","PeriodicalId":12951,"journal":{"name":"Health Services Research and Managerial Epidemiology","volume":"7 ","pages":"2333392820941348"},"PeriodicalIF":1.6,"publicationDate":"2020-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2333392820941348","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38308253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pneumonia Hospitalization Coding Changes Associated With Transition From the 9th to 10th Revision of <i>International Classification of Diseases</i>.","authors":"Ryan B Smithee,&nbsp;Tiffanie M Markus,&nbsp;Elizabeth Soda,&nbsp;Carlos G Grijalva,&nbsp;Wei Xing,&nbsp;Nong Shang,&nbsp;Marie R Griffin,&nbsp;Fernanda C Lessa","doi":"10.1177/2333392820939801","DOIUrl":"https://doi.org/10.1177/2333392820939801","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the impact of <i>International Classification of Disease</i>, 10th revision, Clinical Modification (<i>ICD-10-CM</i>) implementation on pneumonia hospitalizations rates, which had declined following pneumococcal conjugate vaccine introduction for infants in 2000.</p><p><strong>Methods: </strong>We randomly selected records from a single hospital 1 year before (n = 500) and after (n = 500) October 2015 implementation of <i>ICD-10-CM</i> coding. We used a validated <i>ICD-9-CM</i> algorithm and translation of that algorithm to <i>ICD-10-CM</i> to identify pneumonia hospitalizations pre- and post-implementation, respectively. We recoded <i>ICD-10-CM</i> records to <i>ICD-9-CM</i> and vice versa. We calculated sensitivity and positive predictive value (PPV) of the <i>ICD-10-CM</i> algorithm using <i>ICD-9-CM</i> coding as the reference. We used sensitivity and PPV values to calculate an adjustment factor to apply to <i>ICD-10</i> era rates to enable comparison with <i>ICD-9-CM</i> rates. We reviewed primary diagnoses of charts not meeting the pneumonia definition when recoded.</p><p><strong>Results: </strong>Sensitivity and PPV of the <i>ICD-10-CM</i> algorithm were 94% and 92%, respectively, for young children and 74% and 79% for older adults. The estimated adjustment factor for <i>ICD-10-CM</i> period rates was -2.09% (95% credible region [CR], -7.71% to +3.0%) for children and +6.76% (95% CR, -3.06% to +16.7%) for older adults. We identified a change in coding adult charts that met the <i>ICD-9-CM</i> pneumonia definition that led to recoding in <i>ICD-10-CM</i> as chronic obstructive pulmonary disease (COPD) exacerbation.</p><p><strong>Conclusions: </strong>The <i>ICD-10-CM</i> algorithm derived from a validated <i>ICD-9-CM</i> algorithm should not introduce substantial bias for evaluating pneumonia trends in children. However, changes in coding of pneumonia associated with COPD in adults warrant further study.</p>","PeriodicalId":12951,"journal":{"name":"Health Services Research and Managerial Epidemiology","volume":"7 ","pages":"2333392820939801"},"PeriodicalIF":1.6,"publicationDate":"2020-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2333392820939801","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38253570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"After Less Than 2 Months, the Simulations That Drove the World to Strict Lockdown Appear to be Wrong, the Same of the Policies They Generated.","authors":"Alberto Boretti","doi":"10.1177/2333392820932324","DOIUrl":"10.1177/2333392820932324","url":null,"abstract":"<p><p>Here, we review modeling predictions for Covid-19 mortality based on recent data. The Imperial College model trusted by the British Government predicted peak mortalities above 170 deaths per million in the United States, and above 215 deaths per million in Great Britain, after more than 2 months from the outbreak, and a length for the outbreak well above 4 months. These predictions drove the world to adopt harsh distancing measures and forget the concept of herd immunity. China had peak mortalities of less than 0.1 deaths per million after 40 days since first deaths, and an 80-day-long outbreak. Italy, Belgium, the Netherlands, Sweden, or Great Britain flattened the curve at 13.6, 28.6, 9.0, 10.6, and 13.9 deaths per million after 40, 39, 33, 44, and 39 days from first deaths, or 31, 29, 24, 38, and 29 days since the daily confirmed deaths reached 0.1 per million people, respectively. The declining curve is much slower for Italy, the Netherlands, or Great Britain than Belgium or Sweden. Opposite to Great Britain, Italy, or Belgium that enforced a complete lockdown, the Netherlands only adopted an \"intelligent\" lockdown, and Sweden did not adopt any lockdown. However, they achieved better results. Coupled to new evidence for minimal impact of Covid-19 on the healthy population, with the most part not infected even if challenged, or only mild or asymptomatic if infected, there are many good reasons to question the validity of the specific epidemiological model simulations and the policies they produced. Fewer restrictions on the healthy while better protecting the vulnerable would have been a much better option, permitting more sustainable protection of countries otherwise at risk of second waves as soon as the strict measures are lifted.</p>","PeriodicalId":12951,"journal":{"name":"Health Services Research and Managerial Epidemiology","volume":"7 ","pages":"2333392820932324"},"PeriodicalIF":1.6,"publicationDate":"2020-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/77/57/10.1177_2333392820932324.PMC7301657.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38100065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multilevel Risk Factors for Hospital Readmission Among Patients With Opioid Use Disorder in Selected US States: Role of Socioeconomic Characteristics of Patients and Their Community.","authors":"Jayasree Basu","doi":"10.1177/2333392820904240","DOIUrl":"10.1177/2333392820904240","url":null,"abstract":"<p><strong>Research objective: </strong>Using a multilevel framework, the study examines the association of socioeconomic characteristics of the individual and the community with all-cause 30-day readmission risks for patients hospitalized with a principal diagnosis of opioid use disorder (OUD).</p><p><strong>Study design: </strong>The study uses hospital discharge data of adult (18+) patients in 5 US states for 2014 from the Healthcare Cost and Utilization Project of the Agency for Healthcare Research and Quality, linked to community and hospital characteristics using data from Health Resources and Services Administration and American Hospital Association, respectively. A multilevel logistic regression model is applied on data pooled over 5 states adjusting for patient, hospital, and community characteristics.</p><p><strong>Principal findings: </strong>Higher primary care access, as measured by density of primary care providers, is associated with reduced readmission risks among patients with OUD. Medicare is associated with the highest readmission risk (odds ratio [OR] = 2.0, <i>P</i> < .01) compared to private coverage, while Medicaid coverage is also associated with elevated risk (OR = 1.71, <i>P</i> < .01). Being self-pay or covered by other payers carried a similar risk to private coverage. Urban patients had higher readmission rates than rural patients.</p><p><strong>Conclusions: </strong>Patients' risk of readmission following hospitalization for OUD varies according to availability of primary care providers, expected payer, and geographic location. Understanding which patients are most at risk may allow policy makers to design interventions to prevent readmissions and improve patient outcomes. Future studies may wish to focus on understanding when a decreased readmission rate represents better patient outcomes and when it represents difficulty accessing health care.</p>","PeriodicalId":12951,"journal":{"name":"Health Services Research and Managerial Epidemiology","volume":"7 ","pages":"2333392820904240"},"PeriodicalIF":1.6,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/15/54/10.1177_2333392820904240.PMC7265081.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38040326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Women's Decision on Contraceptive Use in Ethiopia: Multinomial Analysis of Evidence From Ethiopian Demographic and Health Survey.","authors":"Zerihun Kura Edossa,&nbsp;Tilahun Fufa Debela,&nbsp;Biru Abdissa Mizana","doi":"10.1177/2333392820924565","DOIUrl":"https://doi.org/10.1177/2333392820924565","url":null,"abstract":"<p><strong>Background: </strong>Women are left out of the conversation on contraceptive use due to a variety of reasons. One of the reasons women have reported for their nonuse of family planning method is that they do not decide to use or not to use it. This study aimed to assess the women's decision-making on contraceptive use and identify its associated factors.</p><p><strong>Methods: </strong>Data for this study were extracted from the national representative 2016 Ethiopian Demographic and Health Survey. Data were collected using 2-stage cluster design, in which enumeration areas forming the first stage and households making the second stage. The analysis was done using multinomial logistic regression using STATA software version 14.</p><p><strong>Results: </strong>The study revealed that one-fourth (24.3%) 95% CI (23.7%-25.1%) decision was made by women. The multinomial analysis demonstrated women's decision-making on contraceptive use was influenced by the age of women 15 to 19 years (adjusted odd ratio [AOR] = 0.327, 95% CI: 0.175-0.613), 20 to 24 years (AOR = 0.510, 95% CI: 0.390-0.666), and 25 to 29 (AOR = 0.557 95% CI: 0.460-0.675); place of residence (urban; AOR = 1.637, 95% CI: 1.331-2.015) and region in which the women dwell and husbands education; occupation of both woman and her husband; and number of children ever born were the factors significantly associated with the outcome variable.</p><p><strong>Conclusions: </strong>Women's decision-making on contraceptive utilization was low. It was influenced by age, place of residence and region, education, occupation, and number of children ever born.</p>","PeriodicalId":12951,"journal":{"name":"Health Services Research and Managerial Epidemiology","volume":"7 ","pages":"2333392820924565"},"PeriodicalIF":1.6,"publicationDate":"2020-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2333392820924565","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37952844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the Efficiency of Health-care Facilities in Sub-Saharan Africa: A Systematic Review.","authors":"Tesleem K Babalola,&nbsp;Indres Moodley","doi":"10.1177/2333392820919604","DOIUrl":"https://doi.org/10.1177/2333392820919604","url":null,"abstract":"<p><strong>Background: </strong>The provision of health-care services is dependent on the effective and efficient functioning of various components of a health-care system. It is therefore important to evaluate the functioning of these various components. Hence, the aim of this study was to review studies on health-care facilities efficiency in sub-Saharan Africa (SSA) with respect to the methodologies used as well as outcomes and factors influencing efficiency.</p><p><strong>Methods: </strong>The review was conducted through a comprehensive search of electronic databases which included PubMed, Web of science, academic search complete via EBSCOhost, Science Direct, and Google scholar. A search was also conducted by looking into citations in the reference list of selected articles and through gray literature. Studies were screened by examining their titles, abstracts, and full-text based on stated inclusion and exclusion criteria. The concurrent screening and data extraction were conducted by the two authors.</p><p><strong>Results: </strong>A total of 40 studies were shortlisted for the review. The majority (90.0%) of the studies employed the data envelopment analysis technique for their efficiency measurements. The input and output variables utilized by most of the studies were predominantly human resources and health-related services respectively. The outcome from majority of the studies showed that less than 40% of the studied facilities were efficient. The leading influencing factors reported by the studies were catchment population, facility ownership, and location.</p><p><strong>Conclusions: </strong>The review showed that there was a marked degree of inefficiency across the health-care facilities. Consequently, due to severe resource constraints facing SSA, there is a need to determine how to use the available resources optimally to improve health systems performance.</p>","PeriodicalId":12951,"journal":{"name":"Health Services Research and Managerial Epidemiology","volume":"7 ","pages":"2333392820919604"},"PeriodicalIF":1.6,"publicationDate":"2020-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2333392820919604","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37952842","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of Patients With Sepsis in Canadian Community Emergency Departments: A Retrospective Multicenter Observational Study.","authors":"Victor C K Lo, Haitong Su, Yuet Ming Lam, Kathleen Willis, Virginia Pullar, Matthew Kowgier, Ryan P Hubner, Jennifer L Y Tsang","doi":"10.1177/2333392820920082","DOIUrl":"10.1177/2333392820920082","url":null,"abstract":"<p><strong>Background: </strong>Sepsis is a life-threatening syndrome and a leading cause of morbidity and mortality representing significant financial burden on the health-care system. Early identification and intervention is crucial to maximizing positive outcomes. We studied a quality improvement initiative with the aim of reviewing the initial management of patients with sepsis in Canadian community emergency departments, to identify areas for improving the delivery of sepsis care. We present a retrospective, multicenter, observational study during 2011 to 2015 in the community setting.</p><p><strong>Methods: </strong>We collected data on baseline characteristics, clinical management metrics (triage-to-physician-assessment time, triage-to-lactate-drawn time, triage-to-antibiotic time, and volume of fluids administered within the first 6 hours of triage), and outcomes (intensive care unit [ICU] admission, in-hospital mortality) from a regional database.</p><p><strong>Results: </strong>A total of 2056 patients were analyzed. The median triage-to-physician-assessment time was 50 minutes (interquartile range [IQR]: 25-104), triage-to-lactate-drawn time was 50 minutes (IQR: 63-94), and triage-to-antibiotics time was 129 minutes (IQR: 70-221). The median total amount of fluid administered within 6 hours of triage was 2.0 L (IQR: 1.5-3.0). The ICU admission rate was 36% and in-hospital mortality was 25%. We also observed a higher ICU admission rate (51% vs 24%) and in-hospital mortality (44% vs 14%) in those with higher lactate concentration (≥4 vs ≤2 mmol/L), independent of other sepsis-related parameters.</p><p><strong>Conclusion: </strong>Time-to-physician-assessment, time-to-lactate-drawn, time-to-antibiotics, and fluid resuscitation in community emergency departments could be improved. Future quality improvement interventions are required to optimize management of patients with sepsis. Elevated lactate concentration was also independently associated with ICU admission rate and in-hospital mortality rate.</p>","PeriodicalId":12951,"journal":{"name":"Health Services Research and Managerial Epidemiology","volume":"7 ","pages":"2333392820920082"},"PeriodicalIF":1.6,"publicationDate":"2020-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2333392820920082","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37878634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Variations in the Delivery of Primary Diabetes Care in Malaysia: Lessons to Be Learnt and Potential for Improvement.","authors":"Feisul Idzwan Mustapha,&nbsp;Jens Aagaard-Hansen,&nbsp;Shiang Cheng Lim,&nbsp;Nazrila Hairizan Nasir,&nbsp;Tahir Aris,&nbsp;Ulla Bjerre-Christensen","doi":"10.1177/2333392820918744","DOIUrl":"https://doi.org/10.1177/2333392820918744","url":null,"abstract":"<p><strong>Background: </strong>The article describes variations in the organization of clinical services for diabetes patients in 10 public primary health clinics in Malaysia with the view to learn from current innovations and improve diabetes service provision.</p><p><strong>Methods: </strong>This study combined the use of secondary data and a qualitative multicase study approach applying observations in 10 randomly selected Ministry of Health (MOH) health clinics in Kuala Lumpur and Selangor and semistructured interviews of the family medicine specialists from the same clinics.</p><p><strong>Results: </strong>Although there are specific MOH guidelines for diabetes care, some clinics had introduced innovations for diabetes care such as the novel 'personalized care', 'one-stop-centre' and utilization of patients' waiting time for health education. Analysis showed that there was room for improvement in terms of task shifting to free precious time of staff with specialized functions, streamlining appointments for various examinations, increasing continuity of consultations with same doctors, and monitoring of performance.</p><p><strong>Conclusion: </strong>We contend that there is a potential for increased effectiveness and efficiency of primary diabetes care in Malaysia without increasing the resources - a potential that may be tapped into by systematic learning from ongoing innovation.</p>","PeriodicalId":12951,"journal":{"name":"Health Services Research and Managerial Epidemiology","volume":"7 ","pages":"2333392820918744"},"PeriodicalIF":1.6,"publicationDate":"2020-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2333392820918744","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37855326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in Mental Well-Being of Non-Hispanic White Children of Midlife Parents With Low Education.","authors":"Neeraj Bhandari","doi":"10.1177/2333392819896966","DOIUrl":"https://doi.org/10.1177/2333392819896966","url":null,"abstract":"<p><strong>Background: </strong>It is unknown whether recent increase in mortality and morbidity linked to mental despair (eg, suicide, opioid addiction, alcoholism) in midlife non-Hispanic whites (NHWs) was accompanied by declines in mental well-being of NHW children. The author examined aggregate trends in the mental well-being of NHW children between 2003 and 2018.</p><p><strong>Methods: </strong>The author used linear (unadjusted) regression to generate estimates of long period (ie, between 2003-2005 and 2016-2018) and annual change in mental well-being and self-assessed health from the National Health Interview Survey data on 68 057 NHW children (aged 4-17 years).</p><p><strong>Results: </strong>The NHW children showed no significant change in any of the tracked indicators (composite Strength and Difficulties Questionnaire [SDQ] 5-item score: long period: -0.03, 95% confidence interval [CI]: -0.09 to 0.02, annual: -0.00, 95% CI: -0.01 to 0.00; severe impairment in mental function: long period: 0.01, 95% CI: 0.00 to 0.02; subjective perception of overall health: long period: -0.01, 95% CI: -0.01 to -0.00). The author did not detect any gradient of worsening SDQ scores with parental midlife status and low parental education. However, the trends in SDQ scores in NHW children were slightly worse than those for children of other major race/ethnic groups.</p><p><strong>Conclusion: </strong>The author did not find evidence of worsening mental distress in NHW children overall or whose parents were in their midlives and less educated.</p>","PeriodicalId":12951,"journal":{"name":"Health Services Research and Managerial Epidemiology","volume":"7 ","pages":"2333392819896966"},"PeriodicalIF":1.6,"publicationDate":"2020-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2333392819896966","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37573241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}