D. Chisolm - Academia.edu (original) (raw)

Papers by D. Chisolm

Research paper thumbnail of Geographic disparities in the risk of perforated appendicitis among children in Ohio: 2001-2003

International Journal of Health Geographics, 2008

Rural-urban disparities in health and healthcare are often attributed to differences in geographi... more Rural-urban disparities in health and healthcare are often attributed to differences in geographic access to care and health seeking behavior. Less is known about the differences between rural locations in health care seeking and outcomes. This study examines how commuting patterns in different rural areas are associated with perforated appendicitis. Controlling for age, sex, insurance type, comorbid conditions, socioeconomic status, appendectomy rates, hospital type, and hospital location, we found that patient residence in a rural ZIP code with significant levels of commuting to metropolitan areas was associated with higher risk of perforation compared to residence in rural areas with commuting to smaller urban clusters. The former group was more likely to seek care in an urbanized area, and was more likely to receive care in a Children's Hospital. To our knowledge, this is the first study to differentiate rural dwellers with respect to outcomes associated with appendicitis as opposed to simply comparing "rural" to "urban". Risk of perforated appendicitis associated with commuting patterns is larger than that posed by several individual indicators including some age-sex cohort effects. Future studies linking the activity spaces of rural dwellers to individual patterns of seeking care will further our understanding of perforated appendicitis and ambulatory care sensitive conditions in general.

Research paper thumbnail of Factors affecting innovation in pediatric surgery: hospital type and appendectomies

Journal of Pediatric Surgery, 2006

Background: There are little data on whether patient or hospital characteristics affect utilizati... more Background: There are little data on whether patient or hospital characteristics affect utilization of innovative surgical techniques in children, especially with respect to laparoscopic appendectomy (LA), whose benefit over existing treatment remains unproven. This study examines the patterns of LA using a national database, focusing on variations in care between children's and general hospitals. Methods: Using data from the 2000 Healthcare Costs and Utilization Project Kid's Inpatient Database for patients aged 5 to 20 years with a discharge diagnosis of appendectomy, we analyzed the relationship between LA and patient demographic and hospital characteristic variables. Results: The Healthcare Costs and Utilization Project Kid's Inpatient Database included 50,825 pediatric appendectomies (26% LA) representing 97,205 cases in the nation. Children's hospitals and children's units were significantly more likely to provide LA (36% and 28%, respectively) than general hospitals (25%). Higher LA rates were also associated with greater patient age, female sex, nonperforated appendicitis, private insurance, and white patient race. The children's hospital effect compared to general hospitals (adjusted odds ratio, 2.11; 95% confidence interval, 1.88-2.38) and all other relationships remained significant in the multivariate model. Conclusion: Utilization of LA is significantly higher in children's hospitals. Children's hospitals appear more likely to adopt innovative surgical procedures, such as LA, even when clear benefit over standard treatment has not yet emerged. D

Research paper thumbnail of Racial and socioeconomic disparity in perforated appendicitis among children: where is the problem?

Child: Care, Health and Development, 2006

This paper describes the development and initial evaluation of an evidence-based transitional car... more This paper describes the development and initial evaluation of an evidence-based transitional care programme recently implemented in a multicentre controlled trial in the United Kingdom. The individual components of the programme are described. Evaluation of the acceptability and utilization of these components employed questionnaires administered to users (adolescents with juvenile idiopathic arthritis and their parents) and providers (rheumatology health professionals). The results confirm the acceptability and utilization of the programme components in addition to further innovative developments during the course of the study. In conclusion, the evidence-based transitional care programme components reported here are acceptable and useful to both user and provider and are potentially feasible in clinical practice in a revised format.

Research paper thumbnail of Survey mode matters: Adults' self-reported statistical confidence, ability to obtain health information, and perceptions of patient-health-care provider communication

Journal of Health Psychology, 2013

This study examined adults' self-reported... more This study examined adults' self-reported understanding and formatting preferences of medical statistics, confidence in self-care and ability to obtain health advice or information, and perceptions of patient-health-care provider communication measured through dual survey modes (random digital dial and mail). Even while controlling for sociodemographic characteristics, significant differences in regard to adults' responses to survey variables emerged as a function of survey mode. While the analyses do not allow us to pinpoint the underlying causes of the differences observed, they do suggest that mode of administration should be carefully adjusted for and considered.

Research paper thumbnail of Geographic disparities in the risk of perforated appendicitis among children in Ohio: 2001-2003

International Journal of Health Geographics, 2008

Rural-urban disparities in health and healthcare are often attributed to differences in geographi... more Rural-urban disparities in health and healthcare are often attributed to differences in geographic access to care and health seeking behavior. Less is known about the differences between rural locations in health care seeking and outcomes. This study examines how commuting patterns in different rural areas are associated with perforated appendicitis. Controlling for age, sex, insurance type, comorbid conditions, socioeconomic status, appendectomy rates, hospital type, and hospital location, we found that patient residence in a rural ZIP code with significant levels of commuting to metropolitan areas was associated with higher risk of perforation compared to residence in rural areas with commuting to smaller urban clusters. The former group was more likely to seek care in an urbanized area, and was more likely to receive care in a Children's Hospital. To our knowledge, this is the first study to differentiate rural dwellers with respect to outcomes associated with appendicitis as opposed to simply comparing "rural" to "urban". Risk of perforated appendicitis associated with commuting patterns is larger than that posed by several individual indicators including some age-sex cohort effects. Future studies linking the activity spaces of rural dwellers to individual patterns of seeking care will further our understanding of perforated appendicitis and ambulatory care sensitive conditions in general.

Research paper thumbnail of Factors affecting innovation in pediatric surgery: hospital type and appendectomies

Journal of Pediatric Surgery, 2006

Background: There are little data on whether patient or hospital characteristics affect utilizati... more Background: There are little data on whether patient or hospital characteristics affect utilization of innovative surgical techniques in children, especially with respect to laparoscopic appendectomy (LA), whose benefit over existing treatment remains unproven. This study examines the patterns of LA using a national database, focusing on variations in care between children's and general hospitals. Methods: Using data from the 2000 Healthcare Costs and Utilization Project Kid's Inpatient Database for patients aged 5 to 20 years with a discharge diagnosis of appendectomy, we analyzed the relationship between LA and patient demographic and hospital characteristic variables. Results: The Healthcare Costs and Utilization Project Kid's Inpatient Database included 50,825 pediatric appendectomies (26% LA) representing 97,205 cases in the nation. Children's hospitals and children's units were significantly more likely to provide LA (36% and 28%, respectively) than general hospitals (25%). Higher LA rates were also associated with greater patient age, female sex, nonperforated appendicitis, private insurance, and white patient race. The children's hospital effect compared to general hospitals (adjusted odds ratio, 2.11; 95% confidence interval, 1.88-2.38) and all other relationships remained significant in the multivariate model. Conclusion: Utilization of LA is significantly higher in children's hospitals. Children's hospitals appear more likely to adopt innovative surgical procedures, such as LA, even when clear benefit over standard treatment has not yet emerged. D

Research paper thumbnail of Racial and socioeconomic disparity in perforated appendicitis among children: where is the problem?

Child: Care, Health and Development, 2006

This paper describes the development and initial evaluation of an evidence-based transitional car... more This paper describes the development and initial evaluation of an evidence-based transitional care programme recently implemented in a multicentre controlled trial in the United Kingdom. The individual components of the programme are described. Evaluation of the acceptability and utilization of these components employed questionnaires administered to users (adolescents with juvenile idiopathic arthritis and their parents) and providers (rheumatology health professionals). The results confirm the acceptability and utilization of the programme components in addition to further innovative developments during the course of the study. In conclusion, the evidence-based transitional care programme components reported here are acceptable and useful to both user and provider and are potentially feasible in clinical practice in a revised format.

Research paper thumbnail of Survey mode matters: Adults' self-reported statistical confidence, ability to obtain health information, and perceptions of patient-health-care provider communication

Journal of Health Psychology, 2013

This study examined adults' self-reported... more This study examined adults' self-reported understanding and formatting preferences of medical statistics, confidence in self-care and ability to obtain health advice or information, and perceptions of patient-health-care provider communication measured through dual survey modes (random digital dial and mail). Even while controlling for sociodemographic characteristics, significant differences in regard to adults' responses to survey variables emerged as a function of survey mode. While the analyses do not allow us to pinpoint the underlying causes of the differences observed, they do suggest that mode of administration should be carefully adjusted for and considered.