Maternal and Child Health Library

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October 5, 2007

1. INITIATIVE LAUNCHED TO HELP STRENGTHEN PUBLIC HEALTH PREPAREDNESS FOR PANDEMIC INFLUENZA

Promising Practices: Pandemic Preparedness Tools aims to enhance public health preparedness for an influenza pandemic and conserve resources by sharing promising practices. The initiative, conceived by the Pew Charitable Trusts, was launched to collect and review practices that can be adapted or adopted by public health stakeholders. Materials were submitted chiefly via survey to state and local experts in pandemic influenza preparedness, and they underwent a peer-review process. The current collection represents a year-long effort and includes more than 130 practices in the following categories and focus areas: models for care (surge capacity, standards of care, triage strategies, out-of-hospital care, collaborations); communication (risk communications, community engagement, resiliency); and mitigation (social distancing). Reviewers' comments have been incorporated into a project description to provide a more complete context for each practice. Practices may also be searched by language, personal preparedness, vulnerable populations, home care, school toolkits, ethics projects, other toolkits, and state. More information, including instructions on submitting a practice, is available at http://pandemicpractices.org.

• Relative to children of women with a college degree, children of women with less than a high school education were 7.1% less likely to be up to date for the 4:3:1:3:3 series, and those of women with a high school degree were 4.6% less likely to be up to date.
• Children of women with less than a high school education were 2.4% less likely to be up to date for the pneumococcal conjugate vaccine than were children of women with a college degree, controlling for all other covariates.
• Although all states manifested negative maternal education gradients for pneumococcal vaccine up-to-date status, those gradients were significantly attenuated by residency in a universal state.

• The rate of preventable adverse events in hospitals is at least an order of magnitude lower for children than for adults.
• Overall, patients enrolled in Medicaid experienced two fewer preventable adverse events than privately insured patients for every 10,000 discharges of each type of patient at risk.
• At the hospital level, there is a pattern of hospitals that reflect higher Medicaid service levels, either in terms of the proportion of Medicaid patients or the amount of disproportionate share hospital (DSH) payments received, having higher PSI rates. (DSH payments are supplemental state and federal funds intended to reduce the financial burden of hospitals treating large numbers of individuals who are uninsured or who are covered by Medicaid.)
• Also at the hospital level, in Medicaid-payer markets, the difference in PSI rates between concentrated and unconcentrated markets is much smaller, and in no case is the difference statistically significant. However, there are statistically significant higher PSI rates in markets with relatively high vs. low enrollment in Medicaid health-maintenance organizations (HMOs).
• At the market level, the odds of experiencing a preventable adverse medical event are 60% higher in a concentrated vs. unconcentrated Medicaid-payer market. In contrast, hospital concentration tends to be protective against adverse events.
• Also at the market level, neither Medicaid HMO enrollment nor overall HMO penetration is statistically significant. There is also no statistically significant relationship among the discharge-level or hospital-level Medicaid variables.