children and adolescents in the United States are healthy or are receiving high-quality health care.


In reviewing the findings presented in the preceding chapters of this report, the committee formulated three sets of conclusions. The first set focuses on the nature, scope, and quality of existing data sources with information about child and adolescent health and health care quality. The second set involves conclusions about gaps in measurement areas that provide opportunities for improving future data collection, analysis, and reporting efforts broadly. These gaps focus in particular on the social and behavioral determinants of health and health care quality and the importance of incorporating a life-course perspective in existing data sets. The third set includes conclusions related to gaps in methodological approaches that would benefit from future attention. These three sets of conclusions provide the foundation for the recommendations that follow, which are framed by a stepwise approach to measuring health and health care quality for children and adolescents.

The Nature, Scope, and Quality of Existing Data Sources

  • Multiple and independent federal and state data sources exist that include measures of the health and health care quality of children and adolescents.
  • The fragmentation of existing data sources impedes access to and timely use of the information they collectively provide.
  • Existing data sources have their individual strengths and limitations, but no single data set derived from these sources provides robust information about the health status or health care quality of the general population of children and adolescents.
  • Lack of standardization in the measurement of disparities in health and health care quality limits the ability to identify, monitor, and address persistent health disparities among children and adolescents. The use of standardized definitions and measures for disparities is especially important as the nation moves toward greater reliance on computer-generated forms and other electronic data sources. Lessons learned from the use of standard formats for classification of race and ethnicity data, as well as for self-identification responses by informants (or parents), can inform the standardization process.
  • Common definitions and consistent data collection methods would improve the standardization of common data elements (such as

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