• a growing realization that children’s and adolescents’ health status and levels of functioning are frequently influenced by social and economic factors;
  • methodological challenges in establishing relationships among children’s and adolescents’ health status, insurance status, use of health care services and their quality, care processes, and health outcomes;
  • the recognition that access to and utilization of high-quality health care services may be insufficient to compensate for adverse social and economic conditions within families and communities; and
  • the persistent inability within various data sets to link measures of children’s and adolescents’ health status with measures of social and economic status and family conditions.

A coordinated approach is a necessary step toward building consensus on the definition of health and the types of health indicators that are important to monitor in assessing the health status of children and adolescents, especially those from disadvantaged and underserved communities.


This chapter has provided an overview of current methods used to collect data and demonstrated how the consistency and rigor of measurement methods are directly associated with the quality of the data collected. In examining the measurement of child and adolescent health and health care, the committee identified several key findings that highlight areas in which current measurement efforts fall short. In particular, the evidence reveals a need for greater consistency, standardization, and interoperability of data.

From its examination of the evidence, the committee determined that consistent standards for data elements, based on common definitions of key concepts, are necessary to facilitate the integration of data across health care systems and geographic areas. In particular, greater consistency is needed in measuring such characteristics as insurance coverage. Improving linkages among administrative record systems and between population-based survey data sets and administrative records would enhance the comprehensive assessment of child and adolescent health and the quality of their health care. Finally, the emergence of EHRs and personal health records (PHRs) has the potential to provide an important and novel source of primary data for assessing health and health care quality. The committee believes that the use and interoperability of EHRs and PHRs will create a robust source of data that can be readily analyzed and acted upon.

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