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Assessing the Quality of Care for Children: Prospects Under Health Reform

Assessing the Quality of Care for Children: Prospects Under Health Reform Abstract The failure to pass federal health reform legislation this year does not mean that the health care crisis has been solved. As we look forward to predictably more incremental efforts to reduce costs, increase access, and improve quality, key issues from the most recent round of deliberations will undoubtedly reemerge. In the last session of Congress, private and public policymakers sent a clear signal that the era of accountability had arrived. In the health reform bills that Congress considered last year, a range of "measurement" strategies were put forth as essential elements for achieving accountability in a reformed health care system. For example, routine monitoring of the quality of care delivered by health plans and health providers was viewed as necessary to balance the impact of policies to control the cost of health care. Each of the major bills that were introduced this past year—Gephardt/Mitchell (S 1757/HR 3600), Cooper/Grandy (HR References 1. Lohr KN, ed, Institute of Medicine , Division of Health Care Services. Medicare: A Strategy for Quality Assurance. Washington, DC: National Academy Press, 1990;1. 2. Kazandjian VA, Lawthers J, Cernak CJM, Pipesh FC. Relating outcomes to processes of care: the Maryland Hospital Association's quality indicator project (QI project) . J Qual Improvement . 1993; 19:530-538. 3. United HealthCare Corporation, Center for Health Care Policy and Evaluation. A Report Card on Health Care: Performance Indicators for Choosing a Health Care Delivery System . Minneapolis, Minn: United HealthCare Corp; 1993. 4. Nadzam DM, Turpin R, Hanold LS, White RE. Data-driven performance improvement in health care: the joint commission's indicator measurement system (IM system) . J Qual Improvement . 1993;19:492-500. 5. Rubin HR, Rogers WH, Kahn KL, Rubenstein LV, Brook RH. Watching the doctor-watchers: how well do peer review organization methods detect hospital care quality problems? JAMA . 1992: 267:2349-2354.Crossref 6. Hannan EL, Kilburn H, Racz M, Shields E, Chassin MR. Improving the outcomes of coronary artery bypass surgery in New York State . JAMA . 1994;271:761-766.Crossref 7. Murata PJ, McGlynn EA, Siu AL, et al. Quality measures for prenatal care: a comparison of care in six health care plans . Arch Fam Med . 1994; 3:41-49. 8. National Committee for Quality Assurance. Health Plan Employer Data and Information Set and Users' Manual, Version 2.0 . New York, NY: National Committee for Quality Assurance; 1993. 9. 1993 Quality Report Card . Oakland, Calif: Kaiser Permanente of Northern California; 1993. Prepared in collaboration with Andersen Consulting. 10. Siu AL, McGlynn EA, Morgenstern H, et al. Choosing quality of care measures based on the expected impact of improved care on health . Health Serv Res . 1992;27:619-650. 11. Brown SS, ed, Institute of Medicine, National Forum on the Future of Children and Families, National Research Council . Including Children and Pregnant Women in Health Care Reform . Washington, DC: National Academy Press; 1992. 12. Jameson EJ, Wehr E. Drafting national health care reform legislation to protect the health interests of children . Stanford Law Policy Rev . 1993;5: 153-176. 13. McManus M, Fox H, Newacheck P, Wicks L. How will children and pregnant women fare under current national health insurance proposals? AJDC . 1992;146:1376-1380. 14. Newacheck PW, Hughes DC, McManus MM, Perrin JM, Valdez RB, Fox HB. Meeting children's long term care needs under the health security act's home and community-based services program. Read before the Child Health Consortium; January 20, 1994; Washington, DC 15. Starfield B. Child and adolescent health status measures . Future of Children . 1992;2:25-39.Crossref 16. Green N, ed. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents . Arlington, Va: National Center for Education in Maternal and Child Health; 1994. 17. Guidelines for the Diagnosis and Management of Asthma . (August) 1991. US Dept of Health and Human Services, Public Health Service, National Institutes of Health publication No. 91-3042. 18. Office of Technology Assessment, US Congress. Healthy Children: Investing in the Future . Washington, DC: Office of Technology Assessment; 1988. 19. Wagner JL, Herdman RC, Alberts DW. Wellchild care: how much is enough? Health Aft (Millwood) . 1989;8:147-157.Crossref 20. US Dept of Health and Human Services. Vital and Health Statistics: Current Estimates From the National Health Interview Survey, 1992 . Series 10: Data from the National Health Survey, No. (189) ; January 1994. US Dept of Health and Human Services publication (PHS)94-1517. 21. Costello EJ, Costello AJ, Edelbrock C, et al. Psychiatric disorders in pediatric primary care: prevalence and risk factors . Arch Gen Psychiatry . 1988; 45:1107-1116.Crossref 22. Offord DR, Boyle MH, Szatmari P, et al. Ontario Child Health Study, II: six-month prevalence of disorder and rates of service utilization . Arch Gen Psychiatry . 1987;44:832-836.Crossref 23. Institute of Medicine. Reducing Risks for Mental Disorders: Frontiers for Preventive Intervention Research . Washington, DC: National Academy Press; 1994. 24. Newhouse JP. Free for All? Lessons From the RAND Health Insurance Experiment . Cambridge, Mass: Harvard University Press; 1993. 25. Stoddard JJ, St. Peter RF, Newacheck PW. Health insurance status and ambulatory care for children . N Engl J Med . 1994;330:1421-1425.Crossref 26. Kleinman LC, Kosecoff J, Dubois RW, Brook RH. The medical appropriateness of tympanostomy tubes proposed for children younger than 16 years in the United States . JAMA . 1994;271:1250-1255.Crossref 27. Kemper KJ. Medically inappropriate hospital use in a pediatric population . N Engl J Med . 1988; 318:1033-1037.Crossref 28. Gloor JE, Kissoon N, Joubert GI. Appropriateness of hospitalization in a Canadian pediatric hospital . Pediatrics . 1993;91:70-74. 29. Eisen M, Ware JE, Donald CA, Brook RH. Measuring components of children's health status . Med Care . 1979;17:902-921.Crossref 30. Walker LS, Greene JW. The functional disability inventory: measuring a neglected dimension of child health status . J Pediatr Psychol . 1991;16: 39-58.Crossref 31. Stein REK, Jessop DJ. Functional status II(R): a measure of child health status . Med Care . 1990; 28:1041-1055.Crossref 32. Lewis CC, Pantell RH, Kieckhefer GM. Assessment of children's health status: field test of new approaches . Med Care . 1989;27( (suppl 3) ):S54-S62.Crossref 33. Townsend M, Feeny DH, Guyatt GH, Furlong WJ, Seip AE, Dolovich J. Evaluation of the burden of illness for pediatric asthmatic patients and their parents . Ann Allergy . 1991;67:403-408. 34. Pantell RH, Lewis CC. Measuring the impact of medical care on children . J Chron Dis . 1987;40 ( (suppl 1) ):99S-108S.Crossref 35. Starfield B, Bergner M, Ensminger M, et al. Adolescent health status measurement: development of the child health and illness profile . Pediatrics . 1993;91:430-435. 36. Perrin EC, Newacheck P, Pless IB, et al. Issues involved in the definition and classification of chronic health conditions . Pediatrics . 1993;91: 787-793. 37. Stein REK, Jessop DJ. What diagnosis does not tell: the case for a noncategorical approach to chronic illness in childhood . Soc Sci Med . 1989; 29:769-778.Crossref 38. Stein REK, Bauman LJ, Westbrook LE, Coupey SM, Ireys HT. A framework for identifying children who have chronic conditions: the case for a new definition . J Pediatr . 1993;122:342-347.Crossref 39. Porges SW, Matthews KA, Pauls DL. The biobehavioral interface in behavioral pediatrics . Pediatrics . 1992;90:789-797. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Pediatrics & Adolescent Medicine American Medical Association

Assessing the Quality of Care for Children: Prospects Under Health Reform

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References (39)

Publisher
American Medical Association
Copyright
Copyright © 1995 American Medical Association. All Rights Reserved.
ISSN
1072-4710
eISSN
1538-3628
DOI
10.1001/archpedi.1995.02170160013002
Publisher site
See Article on Publisher Site

Abstract

Abstract The failure to pass federal health reform legislation this year does not mean that the health care crisis has been solved. As we look forward to predictably more incremental efforts to reduce costs, increase access, and improve quality, key issues from the most recent round of deliberations will undoubtedly reemerge. In the last session of Congress, private and public policymakers sent a clear signal that the era of accountability had arrived. In the health reform bills that Congress considered last year, a range of "measurement" strategies were put forth as essential elements for achieving accountability in a reformed health care system. For example, routine monitoring of the quality of care delivered by health plans and health providers was viewed as necessary to balance the impact of policies to control the cost of health care. Each of the major bills that were introduced this past year—Gephardt/Mitchell (S 1757/HR 3600), Cooper/Grandy (HR References 1. Lohr KN, ed, Institute of Medicine , Division of Health Care Services. Medicare: A Strategy for Quality Assurance. Washington, DC: National Academy Press, 1990;1. 2. Kazandjian VA, Lawthers J, Cernak CJM, Pipesh FC. Relating outcomes to processes of care: the Maryland Hospital Association's quality indicator project (QI project) . J Qual Improvement . 1993; 19:530-538. 3. United HealthCare Corporation, Center for Health Care Policy and Evaluation. A Report Card on Health Care: Performance Indicators for Choosing a Health Care Delivery System . Minneapolis, Minn: United HealthCare Corp; 1993. 4. Nadzam DM, Turpin R, Hanold LS, White RE. Data-driven performance improvement in health care: the joint commission's indicator measurement system (IM system) . J Qual Improvement . 1993;19:492-500. 5. Rubin HR, Rogers WH, Kahn KL, Rubenstein LV, Brook RH. Watching the doctor-watchers: how well do peer review organization methods detect hospital care quality problems? JAMA . 1992: 267:2349-2354.Crossref 6. Hannan EL, Kilburn H, Racz M, Shields E, Chassin MR. Improving the outcomes of coronary artery bypass surgery in New York State . JAMA . 1994;271:761-766.Crossref 7. Murata PJ, McGlynn EA, Siu AL, et al. Quality measures for prenatal care: a comparison of care in six health care plans . Arch Fam Med . 1994; 3:41-49. 8. National Committee for Quality Assurance. Health Plan Employer Data and Information Set and Users' Manual, Version 2.0 . New York, NY: National Committee for Quality Assurance; 1993. 9. 1993 Quality Report Card . Oakland, Calif: Kaiser Permanente of Northern California; 1993. Prepared in collaboration with Andersen Consulting. 10. Siu AL, McGlynn EA, Morgenstern H, et al. Choosing quality of care measures based on the expected impact of improved care on health . Health Serv Res . 1992;27:619-650. 11. Brown SS, ed, Institute of Medicine, National Forum on the Future of Children and Families, National Research Council . Including Children and Pregnant Women in Health Care Reform . Washington, DC: National Academy Press; 1992. 12. Jameson EJ, Wehr E. Drafting national health care reform legislation to protect the health interests of children . Stanford Law Policy Rev . 1993;5: 153-176. 13. McManus M, Fox H, Newacheck P, Wicks L. How will children and pregnant women fare under current national health insurance proposals? AJDC . 1992;146:1376-1380. 14. Newacheck PW, Hughes DC, McManus MM, Perrin JM, Valdez RB, Fox HB. Meeting children's long term care needs under the health security act's home and community-based services program. Read before the Child Health Consortium; January 20, 1994; Washington, DC 15. Starfield B. Child and adolescent health status measures . Future of Children . 1992;2:25-39.Crossref 16. Green N, ed. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents . Arlington, Va: National Center for Education in Maternal and Child Health; 1994. 17. Guidelines for the Diagnosis and Management of Asthma . (August) 1991. US Dept of Health and Human Services, Public Health Service, National Institutes of Health publication No. 91-3042. 18. Office of Technology Assessment, US Congress. Healthy Children: Investing in the Future . Washington, DC: Office of Technology Assessment; 1988. 19. Wagner JL, Herdman RC, Alberts DW. Wellchild care: how much is enough? Health Aft (Millwood) . 1989;8:147-157.Crossref 20. US Dept of Health and Human Services. Vital and Health Statistics: Current Estimates From the National Health Interview Survey, 1992 . Series 10: Data from the National Health Survey, No. (189) ; January 1994. US Dept of Health and Human Services publication (PHS)94-1517. 21. Costello EJ, Costello AJ, Edelbrock C, et al. Psychiatric disorders in pediatric primary care: prevalence and risk factors . Arch Gen Psychiatry . 1988; 45:1107-1116.Crossref 22. Offord DR, Boyle MH, Szatmari P, et al. Ontario Child Health Study, II: six-month prevalence of disorder and rates of service utilization . Arch Gen Psychiatry . 1987;44:832-836.Crossref 23. Institute of Medicine. Reducing Risks for Mental Disorders: Frontiers for Preventive Intervention Research . Washington, DC: National Academy Press; 1994. 24. Newhouse JP. Free for All? Lessons From the RAND Health Insurance Experiment . Cambridge, Mass: Harvard University Press; 1993. 25. Stoddard JJ, St. Peter RF, Newacheck PW. Health insurance status and ambulatory care for children . N Engl J Med . 1994;330:1421-1425.Crossref 26. Kleinman LC, Kosecoff J, Dubois RW, Brook RH. The medical appropriateness of tympanostomy tubes proposed for children younger than 16 years in the United States . JAMA . 1994;271:1250-1255.Crossref 27. Kemper KJ. Medically inappropriate hospital use in a pediatric population . N Engl J Med . 1988; 318:1033-1037.Crossref 28. Gloor JE, Kissoon N, Joubert GI. Appropriateness of hospitalization in a Canadian pediatric hospital . Pediatrics . 1993;91:70-74. 29. Eisen M, Ware JE, Donald CA, Brook RH. Measuring components of children's health status . Med Care . 1979;17:902-921.Crossref 30. Walker LS, Greene JW. The functional disability inventory: measuring a neglected dimension of child health status . J Pediatr Psychol . 1991;16: 39-58.Crossref 31. Stein REK, Jessop DJ. Functional status II(R): a measure of child health status . Med Care . 1990; 28:1041-1055.Crossref 32. Lewis CC, Pantell RH, Kieckhefer GM. Assessment of children's health status: field test of new approaches . Med Care . 1989;27( (suppl 3) ):S54-S62.Crossref 33. Townsend M, Feeny DH, Guyatt GH, Furlong WJ, Seip AE, Dolovich J. Evaluation of the burden of illness for pediatric asthmatic patients and their parents . Ann Allergy . 1991;67:403-408. 34. Pantell RH, Lewis CC. Measuring the impact of medical care on children . J Chron Dis . 1987;40 ( (suppl 1) ):99S-108S.Crossref 35. Starfield B, Bergner M, Ensminger M, et al. Adolescent health status measurement: development of the child health and illness profile . Pediatrics . 1993;91:430-435. 36. Perrin EC, Newacheck P, Pless IB, et al. Issues involved in the definition and classification of chronic health conditions . Pediatrics . 1993;91: 787-793. 37. Stein REK, Jessop DJ. What diagnosis does not tell: the case for a noncategorical approach to chronic illness in childhood . Soc Sci Med . 1989; 29:769-778.Crossref 38. Stein REK, Bauman LJ, Westbrook LE, Coupey SM, Ireys HT. A framework for identifying children who have chronic conditions: the case for a new definition . J Pediatr . 1993;122:342-347.Crossref 39. Porges SW, Matthews KA, Pauls DL. The biobehavioral interface in behavioral pediatrics . Pediatrics . 1992;90:789-797.

Journal

Archives of Pediatrics & Adolescent MedicineAmerican Medical Association

Published: Apr 1, 1995

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