Are pediatric quality care measures too stringent?

Allison Casciato, Heather Angier, Christina Milano, Nicholas Gideonse, Rachel Gold, Jennifer DeVoe

Research output: Contribution to journalArticle

6 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)686-693
Number of pages8
JournalJournal of the American Board of Family Medicine
Volume25
Issue number5
DOIs
StatePublished - Sep 1 2012

Keywords

  • Community health networks
  • Electronic health records
  • Low-income population
  • Pediatrics
  • Quality of health care

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Family Practice

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