Outcomes research in pediatric settings: recent trends and future directions.
OBJECTIVE
Pediatric outcomes research examines the effects of health care delivered in everyday medical settings on the health of children and adolescents. It is an area of inquiry in its nascent stages of development.


METHODS
We conducted a systematic literature review that covered articles published during the 6-year interval 1994-1999 and in 39 peer-reviewed journals chosen for their likelihood of containing child health services research. This article summarizes the article abstraction, reviews the literature, describes recent trends, and makes recommendations for future work.


RESULTS
In the sample of journals that we examined, the number of pediatric outcomes research articles doubled between 1994 and 1999. Hospitals and primary care practices were the most common service sectors, accounting for more than half of the articles. Common clinical categories included neonatal conditions, asthma, psychosocial problems, and injuries. Approximately 1 in 5 studies included multistate or national samples; 1 in 10 used a randomized controlled trial study design. Remarkably few studies examined the health effects of preventive, diagnostic, long-term management, or curative services delivered to children and adolescents.


CONCLUSIONS
Outcomes research in pediatric settings is a rapidly growing area of inquiry that is acquiring breadth but has achieved little depth in any single content area. Much work needs to be done to inform decision making regarding the optimal ways to finance, organize, and deliver child health care services. To improve the evidence base of pediatric health care, more effectiveness research is needed to evaluate the overall and relative effects of services delivered to children and adolescents in everyday settings.
Forrest
Christopher B
CB
Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland 21205, USA. cforrest@jhsph.edu
Shipman
Scott A
SA
Dougherty
Denise
D
Miller
Marlene R
MR
D000293:Adolescent; D002648:Child; D002662:Child Health Services / Q000458:organization & administration* / Q000592:standards / Q000639:trends*; D005544:Forecasting; D006291:Health Policy / Q000639:trends; D006302:Health Services Research / Q000706:statistics & numerical data / Q000639:trends*; D006801:Humans; D018156:Journalism, Medical; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data / Q000639:trends*; D014481:United States