TY - JOUR
T1 - Are pediatric quality care measures too stringent?
AU - Casciato, Allison
AU - Angier, Heather
AU - Milano, Christina
AU - Gideonse, Nicholas
AU - Gold, Rachel
AU - DeVoe, Jennifer
N1 - Copyright:
Copyright 2013 Elsevier B.V., All rights reserved.
PY - 2012/9
Y1 - 2012/9
N2 - Introduction: We aimed to demonstrate the application of national pediatric quality measures, derived from claims-based data, for use with electronic medical record data, and determine the extent to which rates differ if specifications were modified to allow for flexibility in measuring receipt of care. Methods: We reviewed electronic medical record data for all patients up to 15 years of age with ≥1 office visit to a safety net family medicine clinic in 2010 (n = 1544). We assessed rates of appropriate well-child visits, immunizations, and body mass index (BMI) documentation, defined strictly by national guidelines versus by guidelines with clinically relevant modifications. Results: Among children aged <3 years, 52.4% attended ≥6 well-child visits by the age of 15 months; 60.8% had ≥6 visits by age 2 years. Less than 10% completed 10 vaccination series before their second birthday; with modifications, 36% were up to date. Among children aged 3 to 15 years, 63% had a BMI percentile recorded; 91% had BMI recorded within 36 months of the measurement year. Conclusions: Applying relevant modifications to national quality measure definitions captured a substantial number of additional services. Strict adherence to measure definitions might miss the true quality of care provided, especially among populations that may have sporadic patterns of care utilization.
AB - Introduction: We aimed to demonstrate the application of national pediatric quality measures, derived from claims-based data, for use with electronic medical record data, and determine the extent to which rates differ if specifications were modified to allow for flexibility in measuring receipt of care. Methods: We reviewed electronic medical record data for all patients up to 15 years of age with ≥1 office visit to a safety net family medicine clinic in 2010 (n = 1544). We assessed rates of appropriate well-child visits, immunizations, and body mass index (BMI) documentation, defined strictly by national guidelines versus by guidelines with clinically relevant modifications. Results: Among children aged <3 years, 52.4% attended ≥6 well-child visits by the age of 15 months; 60.8% had ≥6 visits by age 2 years. Less than 10% completed 10 vaccination series before their second birthday; with modifications, 36% were up to date. Among children aged 3 to 15 years, 63% had a BMI percentile recorded; 91% had BMI recorded within 36 months of the measurement year. Conclusions: Applying relevant modifications to national quality measure definitions captured a substantial number of additional services. Strict adherence to measure definitions might miss the true quality of care provided, especially among populations that may have sporadic patterns of care utilization.
KW - Community health networks
KW - Electronic health records
KW - Low-income population
KW - Pediatrics
KW - Quality of health care
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U2 - 10.3122/jabfm.2012.05.120041
DO - 10.3122/jabfm.2012.05.120041
M3 - Article
C2 - 22956704
AN - SCOPUS:84866174830
VL - 25
SP - 686
EP - 693
JO - Journal of the American Board of Family Medicine
JF - Journal of the American Board of Family Medicine
SN - 1557-2625
IS - 5
ER -