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Index
[Page numbers followed by b, f, or t refer to in development of new health measures,
boxed text, figures, or tables, respectively.] 190
for health of underserved populations,
151
A for implementation of recommendations,
7
Access and utilization
measurement challenges, 141
in adolescent pregnancy, 45
for population health, 50–51
in conceptual framework of children’s
purpose of quality measurement, 139
health, 61–62, 63f
Accountable care organizations, 147
as determinant of health status, 37–41
Add Health. See National Longitudinal
family factors in, 4, 37, 178
Study of Adolescent Health
goals for health monitoring system, 13,
Administrative records, 69, 71, 74, 76, 251,
65, 94
289–325
insurance and, 37–38
Adult health status
language proficiency and, 31
childhood determinants of, 28, 29,
longitudinal research, 200
38–39, 40–41, 42, 43–44
measurement of disparities in, 58, 194
life-course perspective, 42
patterns and trends, 37–41
Adverse Childhood Experiences, 123–124
preventive and well-child care, 40b, 41b
Affordable Care Act, 10–11, 38, 197, 198,
in public health insurance programs,
248
137–138
Agency for Healthcare Research and
racial and ethnic differences in, 114
Quality, 18, 55–56, 64, 73, 97, 143
Accessibility of data, 2, 19, 124, 126–127b,
assessment of preventive services by, 197
176
in implementation of recommendations,
Accidents. See Unintentional injury
187b, 193, 199, 200, 203, 204–205,
Accountability
207
for community health, 52
Patient Safety Indicators, 320
data needs for, 151
327
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328 INDEX
C
quality improvement efforts, 149–151,
154, 158–160t, 247
Cancer, 33, 55
work on quality indicators, 34b, 35b,
Capacity to use and report data
146, 195–196, 257
challenges in, 58–59
American Academy of Pediatrics, 57,
recent efforts to improve quality
113–114, 164
measurement, 161–162
American Community Survey, 88, 125,
recommendations for improving, 6, 11,
167–168
12–14, 199, 201, 205–207
American Recovery and Reinvestment Act,
stepwise approach to data system
77, 145, 149, 261
improvement, 6, 183, 184
America’s Children, 72, 110
support for states, 195, 207
America’s Uninsured Crisis: Consequences
technical support from federal agencies,
for Health and Health Care, 37
35b
Annie E. Casey Foundation, 129
Care transitions
Annual reports
adolescent to adult, 163–164
current health monitoring system, 137,
chronic disorders, 163
143, 149, 191, 324
life-course perspective for monitoring,
recommendations for, 6, 8, 9, 188, 191,
162, 173
193
longitudinal studies of, 202
stepwise approach to data system
measuring disparities in, 194
improvement, 6, 183–184
monitoring across multiple domains,
Annual Social and Economic Supplement, 78
164–165
Anxiety disorders, 104
prenatal to pediatric, 162–163
Assuring Better Child Health and
rationale for monitoring, 4, 179
Development, 165, 322–323
Case mix adjustment, 79–82
Asthma, 34, 35, 37, 39, 47, 58–59, 100,
Census data, 69, 71
104, 105, 114, 136
Centers for Disease Control and Prevention,
Asthma State Plan, 170–171
35b, 47, 85, 97, 104–105, 106, 107,
Attention-deficit/hyperactivity disorder, 41b,
199, 203, 251
100, 156
Centers for Medicare and Medicaid
Services, 18, 148, 161–162
assessment of preventive services by, 197
B
in implementation of recommendations,
Behavioral disorders, 104, 157, 196–197 187b, 193, 199, 200, 203, 204–205
Behavioral health quality of care measurement, 34b, 35b,
community factors, 46–47 135–136, 143, 146, 149, 151–154,
current data collection, 105–106, 107, 248, 301–302
123 in state data collection efforts, 161–162
life-course perspective, 45–46 vaccine data, 310–311
online data collection, 126b Centers of Excellence, 150–151, 174
parent’s knowledge of child’s, 59 Child and Adolescent Health Measurement
recommendations for measurement, 11, Initiative, 142, 165, 247, 294–295
198–199, 201 Child Health Improvement through
screening, 157–161 Computer Automation, 169
See also Substance abuse Child Poverty in Perspective: An Overview
Behavioral Risk Factor Surveillance Study, of Child Well-Being in Rich
123, 125, 126b Countries, 14, 16
Benchmarking, 56, 75, 148, 151, 161, 289, Children and adolescents, defined, 23–25,
290 75
Beyond the HIPAA Privacy Rule, 84
Breastfeeding, 45
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INDEX
Children’s Health, the Nation’s Wealth, 26, Costs
61, 72, 76, 95, 107, 108, 111, 122, of data collection, 71
141, 165, 179, 184, 206 data needs on, 53, 133
Children’s Health Insurance Program, 16, health care financing, 147
183 health insurance coverage, 38
access to care, 137–138 hospital data, 97
Annual Reporting Template System, 324 of low health literacy, 60b
coverage, 32b in quality of care measurement,
data needs, 53 137–138, 141
data sets, 31, 117–118, 252, 253, 254, rationale for early intervention with
260, 291–292 complex health conditions, 135
definition of child, 75 special health care needs, 100
efforts to standardize data, 162 of standardization of data collection, 77
funding, 32b of unintentional injuries, 36
origins, 143 County Health Rankings, 129, 130, 131f
outcomes data, 51–52 CPONDER, 126b
purpose, 32b Criminal behavior, 46
quality of care measurement, 137, 143, Crossing the Quality Chasm, 33, 141, 144,
145–146, 151–153 245–246
resource allocation, 32b Current Population Survey, 78, 88, 125,
See also Public health insurance 127b, 167–168
programs Cystic fibrosis, 33
Children’s Health Insurance Program
Reauthorization Act, 2, 9, 17, 32b,
D
34b, 35b, 76–77, 93, 137, 143,
145–146, 149, 151, 248, 252, 253 DATA2010, 126b
Children’s Optimal Health, 171–172 Databases, 82–83
Child Well-Being Index, 190 Data collection
Chronic disease conditions for accountability, 151
benefits of early intervention, 37 conceptual framework for, 27f, 59–63,
care transitions, 163 63f, 65, 205
current data system, 100–103 criteria for developing high-quality
functional status measurement, 35–36, systems, 53–54
108, 199 cross-cultural validity, 192
prevalence, 27–28, 100 electronic capture, 5, 182
quality of care assessments, 246–247 emerging technologies for, 184–185
See also Special health care needs, future prospects, 76–77, 84, 198
children with illustrative examples of challenges in,
Clean water supply, 41b 85–88
Clinical Immunization Safety Assessment minimum basic data set, 64–65
Network, 318–319 rationale for improving, 53, 65
Commonwealth Fund, 144 stakeholder interests and, 52
Community Health Data Initiative, 89 terminology, 24b
Consumer Assessment of Healthcare transparency in, 5, 11, 12, 124, 161,
Providers and Systems, 75, 143, 150, 180, 202–204
192, 260 unique identifiers in, 11, 187b, 202, 204,
Consumer Assessment of Health Plans, 252
292–293 See also Data sources; Existing data and
Continuous improvement, 10, 16, 195, 196 data systems; Measures of health
and health care; Quality of care
measurement
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330 INDEX
Data Resource Center for Child and data sources, 33, 113–114, 115–116
Adolescent Health, 126b infant health, 39
Data sources measurement challenges, 191
layering, 168, 171–172, 207 need for standardized measurement of,
medical records, 248 8–9, 176, 191–192
needs of health care system, 50–51 oral health, 115
online, 126–127b in public health insurance programs, 138
recommendations for improving capacity race/ethnicity and, 31, 34, 58, 92,
to use, 6, 11, 12–14, 199, 201, 113–115
205–207 recommendations for measurement of,
recommendations for new, 10–11, 8–9, 193, 194
196–200 shortcomings of current data collection,
See also Data collection; Existing data 3, 57–58, 77–79, 113–118, 176, 192
and data systems; Federal data sociodemographic patterns and, 31
collection and reporting systems; socioeconomic status as source of, 17,
Integration of data sources 31, 58, 78
Data systems, 24b Donabedian model, 49, 61, 245–246
Defense Medical Surveillance System,
309–310
E
Demographic data
case mix adjustment, 79–80 Early Periodic Screening, Diagnosis, and
current data collection system, 4, 178, Treatment, 186b, 197
260 Eating disorders, 45
disparities in health and health care and, Educational achievement and attainment
31 current data collection system, 4, 178
goals for health and health care data health effects on, 39
collection, 94 health insurance and, 37
reference group criteria, 179–180 health outcomes of, 46
significance of, in health care research, in measurement of social determinants
92 of health, 199
smoking risk, 36 parental, 117
standardization issues, 136 study goals, 18–19
See also Educational achievement Electronic data capture, 5, 182
and attainment; Language spoken Electronic health information exchange,
at home and parental language 76, 84
proficiency; Race/ethnicity Electronic health records
Department of Veterans Affairs, 316–317 confidentiality concerns, 84
Diabetes, 40 current implementation, 84
Diet and nutrition, 105, 201 future prospects, 67, 76, 83, 84, 90,
Difficult-to-measure indicators, 1–2, 13, 154 174, 182, 185
Difficult-to-reach populations, 1–2, 13, 154 legislative requirements, 146, 149, 154
Directory of Health and Human Services Emergency medicine, 36
Data Resources, 72 End-of-life conditions, 111–112
Disability, 28, 111 Engaging Privacy and Information
See also Special health care needs, Technology in a Digital Age, 84
children with Evidence-Based Practice Center Program,
Disability in America: Toward a National 195
Agenda for Prevention, 28 Existing data and data systems, 20–21
Disparities in health and health care delivery accessibility, 124, 126–127b, 176
case mix adjustment to study, 81–82 approach for evaluation of, 19–20, 95
current status, 30–33, 57 capacity to monitor trends, 56–57
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INDEX
F
on childhood morbidity and mortality,
96–100
Family Educational Rights and Privacy Act,
on chronic disease conditions, 100–103
181, 201
collection methods, 69–72, 70t, 179–182
Family structure and functioning
development of annual reports from, 8,
in measurement of social determinants
191
of health, 199
development of standardized measures
rationale for measuring, 4, 178
based on, 8, 191
study goals, 18–19
efforts to integrate and aggregate
See also Language spoken at home
databases, 124–128, 128b
and parental language proficiency;
on end-of-life conditions, 111–112
Parents and caregivers
on functional status of children and
Federal data collection and reporting
adolescents, 108–111
systems, 2, 72–73, 274–287t
illustrative examples of challenges in
benchmarking data, 161–162
using, 85–88
current shortcomings, 91
initial observations, 59–65
efforts to improve quality measurement,
key findings, 67, 91–92, 137–138
145–154, 172, 183
life-course perspective in, 121, 123–124
jurisdictional issues, 168
limitations of, 1–2, 3, 4–5, 47–49,
study goals, 18
55–59, 68, 74–85, 89, 90, 99–100,
See also specific program or agency
102–103, 106–107, 110–111,
Federal Interagency Forum on Child and
117–118, 120, 124, 125–128,
Family Statistics, 72, 75, 168, 186b,
130–132, 135–136, 176–179, 191,
193, 200, 201, 303–304
198, 207–208
Federal Quality Workgroup of the CHIPRA
linkage of population health indicators
Steering Committee, 145
with public health interventions,
Fetal programming, 121
129–130, 181
Financing of health care
measurement of disparities in health
pediatric care considerations in payment
and health care, 3, 57–58, 77–79,
reform, 147
113–118
quality improvement and, 147
on preventable common health
Fluoridation, 41b
conditions, 103–107
For the Public’s Health: The Role of
privacy and confidentiality concerns,
Measurement in Action and
84–85
Accountability, 50, 168
range of indicators of child and
Foundation for Accountability, 247
adolescent health, 55–56
Foundations of Lifelong Health Are Built in
on social determinants of health, 51,
Early Childhood, The, 43
118–120, 178
Functional status of children and
standardization issues, 3, 74–76,
adolescents, 7, 26, 28, 29, 55, 61,
176–177
95, 108–111, 132, 136, 173, 179,
stepwise approach to improving, 6,
199
183–184, 185f
Future Directions for the National
timeliness of reporting, 124, 176
Healthcare Quality and Disparities
See also Data collection; Data sources;
Report, 161
Federal data collection and reporting
Future of Public Health, The, 40–41b
systems
External Quality Review Organization,
300–301 G
Geocode mapping, 168
Geographic positioning data, 13, 171–172
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332 INDEX
Goals for child and adolescent health care Health literacy
quality costs of inadequate levels of, 60b
current goal-setting efforts, 3, 190 current patterns, 60b
to prioritize data needs, 63–64 as determinant of health and health care
priority areas, 6–7, 43, 188–189, 190 outcomes, 60b
recommendations for, 6–9, 183, measurement, 4, 60b
189–190 need for improved health education, 60b
sources for, 188 parental, 59, 60b
in stepwise approach to data system rationale for monitoring, 178–179
improvement, 6, 183, 185–188 Health Resources and Services
Great Smoky Mountain Study, 73–74 Administration, 35b, 197, 203
Health status of children and adolescents
adult health outcomes and, 28, 29
H assessment challenges, 27–28
in community context, 28–29, 46–47
HCUPnet, 126–127b
defining, for high-quality data system,
Health, United States, 51
53–54
Health and Human Services, 2, 43, 47, 72,
definition and conceptual scope, 25–30,
150, 252
121, 165
core set of children’s health care quality
determinants of, 1, 4, 26–27, 27f, 61,
measures, 14, 56, 150, 152–153b,
169–170, 178, 179
183, 206, 253
family factors, 4, 178
Federal Quality Workgroup of the
goals for monitoring, 93–94
CHIPRA Steering Committee, 35b
international comparison, 16–17, 34–35
grantee data, 313–314
life-course perspective, 7, 44–45
initial action agenda, 7
need for standardized definitions and
national quality strategy and national
measures of, 75–76
prevention strategy reports, 6, 8, 9,
online data sources, 126–127b
148
patterns and trends, 33–37
recommendations for, 7–14, 186b, 188,
perception of, by children and parents, 75
189–190, 193–194, 195, 197, 199,
poverty effects, 136
201, 203, 206
prevalence of chronic conditions, 27–28,
Universal Claims Database for Health
100
Research, 321
public health intervention outcomes,
Health Care and Education Reconciliation
40–41b
Act, 17, 93
See also Disparities in health and health
Healthcare Cost and Utilization Project, 96,
care delivery; Goals for child and
97–98, 100, 196, 256–260, 257–259t
adolescent health care quality;
Healthcare Effectiveness Data and
Measures of health and health care;
Information Set, 74, 143, 150,
Monitoring health status of children
156, 166, 247, 248, 251, 253–255,
and adolescents
289–290, 291–292
Healthy People 2010/2020, 6, 26–27, 43,
Healthcare Research and Quality Act, 149
45, 47, 51, 52, 126b, 129, 188, 190
Health Data Interactive, 51, 127b
Healthy Start program, 197
Health Indicators Warehouse, 89
Heart disease, 39, 40
Health information technology, 7, 13, 14,
Hospitals
35b, 83, 148, 174, 198
admissions data, 77, 97–98
Health Information Technology for
childhood morbidity and mortality data,
Economic and Clinical Health, 145,
97–99
149, 261
discharge data, 97, 256, 306–307
Health Insurance Portability and
psychiatric follow-up, 156–157
Accountability Act, 83, 84, 181, 201
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INDEX
quality of care assessment, 81–82, Interagency Forum on Child and Family
256–260 Statistics, 190
utilization data, 97 International Classification of Diseases, 75,
76, 83–84
Interview data, 69, 71–72
I
Immunizations, 37, 41b, 80, 310–311,
J
319–320
Indexes, defined, 24b Joint Commission on Accreditation of
Indian Health Service, 35b, 78 Healthcare Organizations, 247
Indicators, defined, 24b
Infant mortality, 17, 34–35, 39, 92, 200
K
Innovation, 152–153
Inpatient care data, 55 Kaiser Permanente, 97
Institute of Medicine, 245–246 Key National Indicators Initiative, 204–205
Insurance, health Kids Count, 129, 190
in adolescent to adult care transitions, Kids’ Inpatient Database, 86, 97–99, 100
163–164 Kids Integrated Data Set, 171, 204
claims data, 97
current coverage, 37, 87–88
L
current data system, 87–88, 101
databases, 167–168 Language spoken at home and parental
as determinant of health care access, language proficiency
37–38 current data collection on, 77, 178
goals for health monitoring system, 94 effects on health and health care, 4, 31,
sources of, 38 57–58
See also Children’s Health Insurance goals for health monitoring system, 94
Program; Medicaid; Medicare; Public implications for surveys of child health
health insurance programs and health care, 192
Integrated framework of health indicators, recommendations for measurement of
21, 89–90, 179–180, 205 disparities in health and health care
Integration of data sources quality, 8–9, 193
birth and death record linkage, 98 Layering of data, 168, 171–172, 207
current efforts and capacity, 56, 59, 90, Leading Health Indicators for Healthy
124–130, 128b, 151, 181 People 2020, 42, 189
demonstration projects for, 207 Leukemia, 33
government jurisdictional issues, 168, Life-course approach, 4
188 conceptual basis, 42, 120–121, 162
illustrative examples of current current data collections with, 121,
challenges, 85–88 123–124, 162
key resources, 256–262 determinants of health in, 42–43, 45–46,
linkage of population health indicators 48f
with public health interventions, illustrative examples, 43–45
129–130, 181 measurement of health, 95, 132
methods, 82–85 measurement of health functioning,
opportunities for, 167–168, 180–181 121–123
rationale, 5, 180, 202, 205 measurement of preventive services
recommendations for, 11–12, 201, 203 outcomes, 11
Title V requirements, 124–125 monitoring care transitions, 162–164
within-state initiatives, 168, 169, 171, policy implications of, 45–47
261–262
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quality of care measurement, 141, 173 recommendations for new, 10–11, 190
rationale, 7, 42, 92, 95, 132, 173, recommendations for periodic review,
181–182 9–10, 194–196
recommendations for, 7, 8, 11, 188–190, research needs, 18–19
193, 197, 199 stepwise approach to improving, 6,
in setting of health and health care 183–184, 185f
goals, 7, 8 validity, 93, 184
trends in health research and practice, whole child approach, 4
43 See also Data collection; Data sources;
Longitudinal data Federal data collection and reporting;
current studies of children and youth, Monitoring health status of children
73–74 and adolescents; Quality of care
rationale for collecting, 5, 12, 181–182, measurement; Standardization in
202 measurement
recommendations for, 11, 200 Media exposure, 201
Low birth weight, 37, 39–41, 121 Medicaid, 2, 147
access to care, 137–138
administration, 32b
M data collection system, 31, 76–77,
78, 85, 117–118, 135–136, 137,
Managed care, 253, 254
161, 162, 204, 254, 260, 291–292,
Maternal and Child Health Bureau, 32b,
312–313, 325
43, 45, 55, 75–76, 86, 251–252
data needs, 53
Measures of health and health care
definition of child, 75
for accountability assessment, 141, 151
distribution of expenditures, 32b
case mix adjustment, 79–82
eligibility system data, 314–315
Children’s Health Insurance Program
enrollment patterns, 32b
Reauthorization Act requirements,
outcomes data, 51–52
34b, 35b
purpose, 32b
core set, 14, 64, 149–150, 155–156, 206
quality of care measurement, 34b, 137,
current system, 1, 3, 4, 8, 21, 130–132,
143, 151–153
177–179
in stepwise approach to improving
definition, 24b
health care data system, 183
developmental status, 122
See also Insurance, health; Public health
four D’s of pediatric medicine, 142
insurance programs
functional status, 136, 179
Medicaid and CHIP Payment Access
goals for, 51–53, 93–94, 133, 135, 184
Commission, 34b, 145
health functioning measurements,
Medicaid Statistical Information System,
121–123
192, 204, 251, 252–253, 311–312
integrated framework for, 21, 179–180
Medicaid Transformation Grant, 76–77
life-course perspective for, 95, 132
Medical data registries, 83
methodology for evaluating, 95
Medical Expenditure Panel Study, 85, 88,
minimum basic data set, 64
96, 97, 98, 167–168
need for coordinated approach to
Medical home concept, 29, 37, 119, 147
integrate, 89–90
Medical Homes Practice Measures, 295–296
for preventive services assessment, 136,
Medicare, 147, 261, 312–313
140–141
See also Public health insurance
priority areas, 7, 43, 63–64, 95, 132,
programs
188–189, 190
Medicare Hospital Compare, 290–291
process measures, 51, 141
Medstat Marketscan, 97
psychological functioning, 93
rationale for improving, 1, 16, 65, 92
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INDEX
N
Mental health
assessment technology, 93
National Advisory Council Subcommittee
coordination of care, 157
on Children’s Healthcare Quality
developmental screening, 41b
Measures for Medicaid and Child
hospital admissions, 98
Health Insurance Programs,
life-course approach to health care, 45
149–150, 155–156
longitudinal studies of youth, 73–74
See also Subcommittee of the National
prevalence of disorders, 36, 104, 156,
Advisory Committee
196–197
National Ambulatory Medical Care Survey,
psychiatric hospital follow-up, 156–157
127b, 307–308
quality of care, 156–161
National Center for Education Statistics,
racial and ethnic differences, 114–115
125
recommendations for measurement, 11,
National Center for Health Statistics, 36,
194, 197
97, 99–100, 104, 112, 126b, 127b,
screening, 157–161
203, 256, 305–306
shortcomings of current data system,
National Children’s Study, 73, 119–120
55–56, 154
National Committee for Quality Assurance,
MEPSnet/HC, 127b
74, 142, 164, 247, 253, 289
Monitoring health status of children and
National Death Index, 102
adolescents
National Health and Nutrition Examination
approach to assessing current system of,
Survey, 36, 104, 105, 106, 107, 109,
19–20
127b, 168
capacity to monitor trends, 56–57, 94
National Health Care Quality Strategy,
in care transitions, 4, 162–164, 173, 179
147–148
challenges in, 27–28, 89–90
National Health Care Survey, 127b
conceptual framework for, 27f, 59–63,
National Health Information Network,
63f, 65, 205
204–205
current shortcomings, 1, 3, 47–49,
National Health Information Survey, 251
54–58, 67, 91, 175–176
National Health Interview Survey, 24b, 36,
goals, 53, 93–94
88, 100, 102, 104, 107, 109, 110,
historical and conceptual evolution, 92–93
127b, 167–168, 256
rationale, 1, 15–16, 67–68, 175
National Home and Hospice Care Survey,
responsibility for, 206–207
112, 127b
sentinel measures of quality of care, 156
National Hospital Ambulatory Medical
study goals, 17–19
Care Survey, 127b, 308–309
See also Data collection; Measures of
National Hospital Discharge Survey, 127b,
health and health care; Screening
306–307
Mood disorders, 104. See Behavioral health
National Immunization Survey, 24b, 127b
Mortality patterns and trends, 33
National Information Center on Health
from accidental injury, 36
Services Research and Health Care
among children and adolescents, 111–112
Technology, 72
birth and death record linkage, 98
National Initiative for Children’s Healthcare
childhood obesity and, 39
Quality, 142, 247, 248
current data sources, 96–100
National Institute of Mental Health, 36
infant, 17, 34–35, 200
National Institute on Alcoholism and
leading causes of death, 96, 96b
Alcohol Abuse, 107
public health intervention outcomes,
National Institute on Drug Abuse, 107
40–41b
National Institutes of Health, 111
quality of care measurement, 141
National Longitudinal Study of Adolescent
racial and ethnic differences, 114, 115
Health, 73–74, 109–110, 123
Multi-State Foster Care Data Archive, 204
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P
National Medicaid Quality Framework,
301–302
Panel Survey of Income Dynamics, 121
National Prevention and Health Promotion
Parents and caregivers
Strategy, 148, 197
barriers to effective health care for
National Prevention Strategy, 10–11
children, 59
National Quality Forum, 142, 246–247,
child health outcomes for, 29
248, 296–297
as data source on children’s health, 103,
National Quality Strategy, 147–148
169
National Research Council, 167–168
as determinants of child health care
National Survey of American Families, 125
access and outcomes, 4, 37, 58, 178
National Survey of Child and Adolescent
educational attainment, 117
Well-being, 116–117, 118
engagement in data collection effort, 12
National Survey of Children’s Health, 38,
health literacy, 4, 59, 60b
100–101, 102–103, 104, 119, 165,
knowledge of child’s behavioral health,
199, 251–252, 255
59
National Survey of Children with Special
perception of child’s health, 75
Health Care Needs, 24b, 101, 102,
See also Language spoken at home and
109, 110, 199, 251–252
parental language proficiency
National Survey of Early Child Health, 101,
Patient Protection and Affordable Care Act
102, 251–252
(ACA), 17, 93, 145, 147–149. See
National Survey of Family Growth,
Affordable Care Act
104–105, 106, 107
Patient-Reported Outcomes Measurement
National Vital Statistics System, 96, 98,
Information System, 111
125, 127b, 153
Patient Safety and Quality Improvement
Neighborhood and community health
Act, 84
accountability issues, 52
Payment for health care
health care in community context,
data collection challenges, 77
28–29, 46–47, 78
value-based approaches, 198
measurement of social determinants of
Pediatric ACO Demonstration project, 147
health, 199, 200
Pediatric Data Quality System Collaborative
National Prevention and Health
Measure Working Group, 247
Promotion Strategy, 148
Pediatric Quality Measures Program, 156
place-based measurement, 179
Performance Measurement: Accelerating
as source of health status disparities in
Improvement, 163, 179
the United States, 58
Personal health records, 83, 90
See also Social determinants of health
Physician Quality Reporting Initiative, 261,
Neonatal intensive care, 55
297–299
Newborn screening, 13
Place-based measures, 13, 179, 205
Nursing Home Survey, 112
Population-based data collection, 69–70, 71
Population health efforts
current data sets for, 20, 31, 50–51,
O
72–73, 190, 251, 274–287t
Obesity, 35, 39, 44, 45, 104, 105, 108 data needs, 52
Office of the National Coordinator for linkage among data sets for, 5, 6, 13, 31,
Health Information Technology, 35b 52
Oral health, 104, 115, 194, 196 linkage with public health intervention
recommendations for measurement, 11, data, 129–130, 181
197 opportunities for improved data
Out-of-home care, children in, 113 collection, 201
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quality of care measurement, 139–140, rationale, 10
251–252 recommendations for data collection,
using metrics to drive improvement in, 10–11, 13, 194, 196–198
51–53 sentinel measures of quality of care, 156
Population patterns and trends See also Immunizations; Screening
age, 30 Privacy and confidentiality issues, 5, 12,
health status, 35–36, 39 84–85, 181, 182, 203, 204
insurance coverage, 37 Private sector
race/ethnicity, 9, 30, 192 collaboration on core set of standardized
See also Demographic data measures, 64
Post-Licensure Rapid Immunization Safety development of quality measures in,
Monitoring, 315–316 135b
Poverty incentives for health care quality
implications for health, 136 measurement, 172, 182
measurement challenges, 78 initiatives to advance quality of care and
patterns and trends, 8–9, 16, 30, 31–33, quality measurement, 245–248
78, 136 insurance coverage, 38
See also Social determinants of health role in quality improvement in health
Pregnancy care, 147, 148, 198
adolescent, 45, 46, 98 Promoting Health Development Survey,
birth and death record linkage, 98 165–166
current data collection, 104 Protective factors, 121–123
linking prenatal care data with pediatric Public health insurance programs
records, 162–163 application forms data, 260
measurement of disparities in prenatal data needs, 52, 53
care, 194 enrollment patterns and trends, 9, 16,
Vaccines and Medications in Pregnancy 31, 38
Surveillance System, 319–320 goals for health data collection, 133
Pregnancy Risk Assessment and Monitoring historical development, 143
System, 104, 106, 126b outcomes data, 51–52
Pregnancy to Early Life Longitudinal Data quality of care measurement and
System, 169 reporting, 137, 143
President’s Advisory Commission on See also Children’s Health Insurance
Consumer Protection and Quality in Program Reauthorization Act;
the Healthcare Industry, 54 Medicaid; Medicare
Preterm births, 39–41 Public health interventions, 40–41b
Preventable common health conditions
current data system, 103–107
Q
trends, 104
Preventive services Quality Improvement System for Managed
adolescent pregnancy, 45 Care, 299–300
current utilization, 40b Quality of care
defining, for high-quality data system, access and utilization issues in, 50,
54 61–62
gaps in current measurement, 3 Centers of Excellence demonstration
insurance as determinant of access to, 37 projects, 150–151
measurement challenges, 136, 140–141 in conceptual framework of
National Prevention and Health determinants of children’s health,
Promotion Strategy, 148 61–62, 63f
quality of care measurement, 165–166, defining essential services for evaluation
177 of, 54
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demonstration grants, 145 mental health and substance abuse
goal setting, 6–7, 8, 183 measures, 156–161
language barriers to, 57–58 opportunities for improving, 4, 5, 12,
measurement of. See Quality of care 14, 16, 173–174
measurement optimal features, 141–142
mental health services, 156–161 periodic review of, 9–10, 194–195
national strategy, 147–148 in preventive services, 11, 165–166,
opportunities to improve, 158–160t, 173 172–173, 177
private sector initiatives, 245–248 priority areas, 6–7, 10, 188–189
in public health insurance programs, in private care settings, 198
137–138 private sector initiatives, 245–248
recommendations for annual report on, in public health insurance programs,
9, 193 137, 143
social determinants of, 11, 173, purpose of, 139–140, 175
198–199, 201 recent efforts to improve, 34–35b,
stepwise approach to data system 145–154, 173, 182–183, 195–196
improvement, 6, 183–184, 185f safety measures, 144
See also Disparities in health and health salient issues, 138–139
care delivery scope of, 49–50, 144
Quality of care measurement sentinel measures, 156
across multiple domains, 164–165 shortcoming of current system, 1, 3,
age group specificity, 144 8, 31, 54–55, 135–136, 142, 144,
aspirational measures, 155 172–174, 183
in care transitions, 162–164 stakeholder objectives in, 140
challenges, 49, 136, 182 structure and process considerations in,
conceptual approach to, 49 50, 141
continuous improvement, 196 study goals, 2, 17, 18, 20
core set of measures, 10, 14, 34b, validity of measures, 155, 183
149–150, 151, 152–153b, 155–156,
183, 196, 206
R
data needs, 15–16, 52, 173–174
data sources, 50, 251–262 Race/ethnicity
effectiveness measures, 137, 138b access to care in public health insurance
feasibility criterion for evaluation of programs, 138
measures, 155 case mix adjustment for data analysis of,
goals of, 10, 12–13, 161, 184 81, 82
government jurisdictional issues, 168 current data collection system, 4, 57,
grounded measures, 155 77–78, 117–118, 178, 192, 260
impediments to development of, goals for health monitoring system, 94
140–141 health and health care disparities and,
importance criterion for evaluation of 31, 34, 58, 92b, 113–115
measures, 155–156 health insurance coverage and, 38, 192
initial efforts to develop, 142–144 mortality patterns, 114
integration of data with other health need for improved data collection,
system data, 52 78–79, 154, 178, 192–193
intermediate measures, 155 population trends, 9, 30, 192
key findings, 135–136 preventive care utilization and, 40b
life-course perspective in, 42–43, 141, recommendations for measurement of
173 disparities in health and health care,
medical home concept and, 29 8–9, 193
RAND Corporation, 248
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Real Time Immunization Monitoring Sexual and reproductive health, 45, 46, 47,
System, 317–318 105. See also Pregnancy; Sexually
Recommendations, 21 transmitted infections
for annual reporting of child and Sexually transmitted infections, 45, 105,
adolescent health and health care 197
quality, 9, 193 Smart targeting, 204–205
for development of standardized Smoking, 36–37, 47, 105–106
measures to reduce health and health Social determinants of health
care quality disparities, 8–9, 193 in conceptual framework of children’s
implementation actions for, 186–187b, health, 26–27, 27f, 61
193–194, 197–198, 199–200, 201, in county health ranking model,
203–205, 207–208 169–170
to improve capacity to link data sources, current data collection system, 4, 51,
11, 201, 203, 205–207 118–120, 178
to improve data collection and reporting, gaps in monitoring, 3, 4, 57, 178
11, 199, 200, 202–205 life-course perspective, 45–47
for interagency collaborations, 11, 199 as priority area for data collection, 7,
for new measures and data sources, 95, 188–189
10–11, 190, 196–200 recommendations for measurement, 11,
for periodic review of health and 198–199, 201
health care quality measures, 9–10, study goals, 18–19
194–196 Social Security Act, 124–125
for setting goals for child and adolescent Socioeconomic status
health, 6–8, 189–190 case mix adjustment for data analysis of,
stepwise approach to implementation, 6, 81–82
183–184, 185f childhood health as factor in, 39
Reference groups, 5, 13, 179–180 costs for families with special health care
Reporting of health and health care quality needs child, 29
findings current data collection system, 4, 78, 90,
accessibility issues, 124, 126–127b 113, 115–116, 117, 178
confidentiality issues, 84–85 goals for health monitoring system, 94
public health insurance program health insurance coverage and, 38
requirements, 137, 143 measurement challenges, 78
recommendations for, 9, 193 in measurement of social determinants
study goals, 18 of health, 199, 200
timeliness, 124 preventive care utilization and, 40b
Title V requirements, 124–125 quality of care measurement, 173
See also Annual reports recommendations for measurement of
Respondent-based data, 69, 71 disparities in health and health care
Robert Wood Johnson Foundation, 129, quality, 8–9, 192, 193
130 reference group criteria, 179–180
significance of, in health outcomes, 92
as source of health status disparities in
S the United States, 17, 31, 58, 78
See also Poverty
Samples, population, 69
Special health care needs, children with
Screening, 165, 197
access to care in public health insurance
developmental, 41b
programs, 138
mental health, 157–161
costs for families of, 29
newborn, 13
current data collection system, 55, 101
Service-based data collection, 70, 74
definition, 55
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health care expenditure for, 100 data warehousing capabilities, 261
medical home concept, 119 efforts to improve quality measurement
population patterns and trends, 36, 55, capacity, 150–154, 161–162,
100, 108 168–172, 173
quality of care measurement, 136 recommendations for data collection, 14,
race/ethnicity and, 9, 192 204
recommendations for measurement of recommendations for improving capacity
disparities in health and health care to use data sets, 6, 12–14
quality, 8–9, 193, 194 reporting of health outcomes data,
See also Chronic disease conditions; 124–125
Disability support for measurement efforts in, 195,
Specialty medicine, 37, 137–138 207
Standardization in measurement Stratified reporting, 80
case mix adjustment strategies, 79–80 Subcommittee of the National Advisory
core set of health and health care quality Committee, 64
measures, 14, 206 See also National Advisory Council
costs and benefits, 77 Subcommittee on Children’s
current data collection system, 3, 67, Healthcare Quality Measures for
74–76, 91, 132, 176–177, 192, 254 Medicaid and Child Health Insurance
of disparities in health and health care Programs
quality, 8–9, 176, 191–192 Substance abuse, 11, 45, 46, 154, 156–161,
of essential health services, 54 197
federal leadership, 168, 206–207 Substance Abuse and Mental Health
functional status measures, 136 Services Administration, 35b, 107,
future prospects, 151 119
improving state capacity for, 161–162 Sudden Infant Death Syndrome, 37
innovation in measurement and, Supplemental Security Income, 101
152–153 Surgeon General, 36
minimum basic data set for, 64–65 Surveillance systems, 50–51. See also
model-based, 80 Monitoring health status of children
need for, in public health insurance and adolescents
program, 137 Survey of Income and Program
need for periodic review of measures, Participation, 115–116, 168
194 Systemized Nomenclature of Medicine,
recommendations for, 6, 9, 90, 193 83–84
for state quality reporting, 152–153
in stepwise approach to data system
T
improvement, 6, 183–184
State and Local Area Integrated Telephone Telephone surveys, 102–103. See also State
Survey, 86, 101, 102–103, 104. See and Local Area Integrated Telephone
also Telephone surveys Survey
State Children’s Health Insurance Program, Timeliness of data, 11–12, 124, 176, 203
32b, 143, 254 Title V program, 101, 124–125
States To Err Is Human: Building a Safer Health
capacity to integrate data from, 75 System, 245
capacity to integrate data within, Transparency in data collection, 5, 11, 12,
261–262 124, 161, 180, 202–204
confidentiality of medical data, 85
data sets for studying disparities in
health and health care, 117–118
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U W
Underserved populations, 5, 10, 48–49, 151 Well-child services, 37, 38, 40b, 150, 152b,
161, 165, 166, 167b
Unequal Treatment: Confronting Racial and
Ethnic Disparities in Health Care, 57 Wellpoint/HealthCore, 97
UNICEF, 15, 16 When Children Die, 112
Unintentional injury, 36, 96, 98, 127 WISQARS™, 127b
Unique identifiers, 11, 187b, 202, 204, 252 World Health Organization, 25, 28, 111
V Y
Vaccines. See Immunizations Young Adult Health Care Survey, 165
Vaccines and Medications in Pregnancy Youth Online, 127
Surveillance System, 319–320 Youth Risk Behavior Surveillance System,
Vulnerable populations 105, 106, 107, 119, 127
current data sources, 4, 179
goals for health monitoring system, 10,
94, 199
quality of care assessments, 173
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