Child and Adolescent Health and Health Care Quality Measuring What Matters (2011) / Chapter Skim
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Appendix D: Overview of Data Sources for Measures of Health Care Quality for Children and Adolescents
Appendix D: Overview of Data Sources for Measures of Health Care Quality for Children and Adolescents
Pages 251-262
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From page 251... ...
In addition to the above two administrative data sources, quality measures can be found in population health surveys, especially in the data sets compiled by the National Health Information Survey (NHIS) for the Centers for Disease Control and Prevention and three surveys conducted by the Maternal and Child Health Bureau (MCHB)
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From page 252... ...
On the positive side, state-level files contain data on claims and encounters for services, which include data on health insurance, diagnoses, and the services or procedures provided as core data elements. The records contain a state-assigned unique personal identifier; this identifier can be used consistently to identify a given individual across different years and different enrollment periods, making it possible to track Medicaid beneficiaries over time within that state (MacTaggart, 2010)
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From page 253... ...
Since CHIPRA now requires states to compare the status of children and adolescents served by public plans with that of the general population of children and adolescents on a statewide basis, MSIS data can provide only a partial picture of the services or outcomes of those who are enrolled in Medicaid or Medicaid-expansion CHIP plans. HEDIS Currently, administrative data from the HEDIS collection of data from managed care plans are a primary source of information at the state level for reporting on current and new quality-of-care measures.
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From page 254... ...
. Thus, although almost 90 percent of Medicaid programs and 100 percent of CHIP programs reported using HEDIS access and effectiveness measures related to child health in 2009, the data may not be comparable across states (Smith et al., 2009)
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From page 255... ...
Survey questions encompass child health status and health conditions, health insurance and medical home, parental health, school engagement, media exposure, youth activities, and neighborhood conditions. The NSCH produces estimates for numerous demographic, socioeconomic, and health status subgroups of children, including whether their health insurance coverage is public or private, whether they have special health care needs, their race/ethnicity, their primary language, whether they are foreign born or adopted, the immigration status of their parents, their household income, and the household's use of public assistance.
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From page 256... ...
From this core set of discharge information, several subsets of data can be extracted to create inpatient, ambulatory care, emergency care, and child-specific databases, as shown in Table D-1. Each database in turn can be used to examine quality of care with the AHRQ quality indicators, to
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From page 257... ...
, for the quality of care received in hospitals; the Prevention Quality Indicators (PQI) , for potentially preventable hospital admissions; and the Patient Safety Indicators (PSI)
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Indicators Patient Safety Quality Used for quality of care inside the hospital as well as Indicators potentially avoidable complications. Pediatric Quality Used for quality of care inside the hospital as well as Indicators potentially avoidable complications for children (under age 18)
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From page 259... ...
per 1,000 eligible admissions Postoperative Hemorrhage and Number of patients with postoperative hemorrhage Hematoma or hematoma requiring a procedure per 1,000 eligible admissions Postoperative Respiratory Number of patients with respiratory failure per Failure 1,000 eligible admissions Postoperative Sepsis Number of patients with sepsis per 1,000 eligible admissions Postoperative Wound Number of abdominopelvic surgery patients with Dehiscence disruption of abdominal wall per 1,000 eligible admissions Selected Infection Due to Number of patients with specific infection codes per Medical Care 1,000 eligible admissions Transfusion Reaction Number of patients with transfusion reaction per 1,000 eligible admissions Pediatric Heart Surgery Number of in-hospital deaths in patients undergoing Mortality Rate surgery for congenital heart disease per 1,000 patients Pediatric Heart Surgery Volume Number of patients undergoing surgery for Rate congenital heart disease Area-Level Indicators Asthma Admission Rate Number of patients admitted for asthma per 100,000 population Diabetes Short-Term Number of patients admitted for short Complications Admissions term complications of diabetes (ketoacidosis, Rate hyperosmolarity, coma) per 100,000 population Gastroenteritis Admission Rate Number of patients admitted for gastroenteritis per 100,000 population Perforated Appendix Admission Number of patients admitted for perforated Rate appendix per 100 admissions for appendicitis within an area Urinary Tract Infection Number of patients admitted for urinary tract Admission Rate infection per 100,000 population
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From page 260... ...
Application Forms for Public Insurance Application forms for public insurance (Medicaid and CHIP) are a source of demographic information because they ask parents about their child's or adolescent's race, ethnicity, age, gender, income, and in some cases language.
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From page 261... ...
Examples of Data Warehouses and State-based Linkage Activities Although states vary in their capabilities to collect, store, and analyze data, some states, such as New York, Georgia, and Kentucky, have strong warehousing capabilities, including in some cases the ability to link state databases. New York, for example, collects member-level data reported by Medicaid managed care plans (for all members)
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From page 262... ...
2009. Medicaid and CHIP strategies for improving child health.
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