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Explores the situations of "missing" children and discusses sources of information about these children. More than 99% of all missing child cases reported to police in 1996 were successfully resolved, but data suggest that about 150,000 children each year are hurt physically or mentally during the time they are missing. (SLD)

Examines the measurement of class size and a related measure, the student-teacher ratio, and considers the variations across states in class size and student-teacher ratios. Student-teacher teacher ratios are consistently lower than average class size because class-size figures do not reflect the use of specialized teachers or those who work in multiple classrooms. (SLD)

Analyzes implications of the birthrate for teenage mothers, and examines the limitations of key statistical indicators. Evidence suggests that the rate of childbearing among U.S. teens may be increasing after a decade of stability. To deal with this effectively, it may be necessary to enhance life options of teenagers. (SLD)

Analyzes annual medical expenditures for childhood (conception through age 18 years). A decline in the relative share of children's medical expenditures means that their health care will become more affordable compared to other groups. The least budget impact will result from expanding insurance coverage for 3- to 12-year-old children. (SLD)

The staff of the Center for the Future of Children analyzes policies to make the U.S. health care system more responsive to the needs of children and pregnant women focusing on (1) efficiency; (2) access; and (3) affordability. Recommendations are made in each of these areas. (SLD)

Examines a frequently discussed indicator of child well-being, the high school dropout rate. School-linked services will be successful only to the extent children are in school. First in a feature series ("Child Indicators") that analyzes implications and limitations of key statistical indicators of the well-being of children. (SLD)

Differences in death rates in neonatal intensive care units (NICUs) may be due to differences in effectiveness of care. Researchers compared outcomes among 62 NICUs for 7,672 infants weighing 501 to 1,500 grams at birth. Death rates within 28 days ranged from 10% to 18% and averaged 15% overall. After making statistical adjustments for variations in the admission characteristics of the infants, neither the volume of very-low-birth-weight patients per year nor the presence of a residency program explained the differences between NICUs., Background. The outcomes for very low birth weight infants vary among neonatal intensive care units (NICUs), but the reasons for this variation are not well understood. We used the database of a large neonatology research network to determine whether either admission characteristics of the infants or specific characteristics of the units such as annual patient volume and the presence of a pediatric residency program could account for observed differences in neonatal mortality rates among units. Methods. We studied 7672 infants with birth weights from 501 to 1500 g treated during 1991 and 1992 at 62 NlCUs participating in the Vermont Oxford Network Database. Results. Overall, 14.7% of the study infants died within 28 days of birth (interquartile range 9.9% to 18.1%). The ratio of the number of observed deaths at an NICU to the number of deaths predicted based on the characteristics of infants treated at the NICU (standardized neonatal mortality ratio, [SNMR]) varied significantly among units (range 0 to 1.69, z = 4.24). There was no association between annual patient volume and either mortality rate (r = .17) or SNMR (r = .22). Observed mortality rates (17% vs 13%) and SNMR (1.04 vs .87) were both higher at the 24 hospitals with pediatric residency training programs than at the 38 hospitals without such programs. Hospitals with residency programs had higher average annual patient volumes (104 vs 66). In an analysis simultaneously adjusting for patient characteristics, volume, and presence of a residency program, neither volume (odds ratio IOR] per 10 additional cases treated 1.01, 95% confidence interval [CI], .98 to 1.04) nor presence of a pediatric residency program (OR 1.18, 95% CI, .94 to 1.47) was significantly associated with neonatal mortality risk. Conclusion. There are differences in neonatal mortality rates among NICUs that cannot be explained by differences in the measured admission characteristics of the infants, suggesting that the effectiveness of medical care varies among units. Neither the annual volume of very low birth weight infants treated in a unit nor the presence of a pediatric residency training program was independently associated with neonatal mortality rates for very low birth weight infants. Pediatrics 1997;99:149-156; neonate, very low birth weight, mortality, variation, volume, residency training., ABBREVIATIONS. NICU, neonatal intensive care unit; OR, odds ratio; CI, confidence interval; ROC, receiver operating characteristic; SNMR, standardized neonatal mortality ratio; CRIB, clinical risk index for babies; SNAP, score for [...]