Burden of illness for children and where we stand in measuring the quality of this health care
Burden of illness for children and where we stand in measuring the quality of this health care
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DOI：
10.1367/a04-229r.1
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发表时间：
2005-09-01
期刊：
影响因子：
--
通讯作者：
Zhan, CL
中科院分区：
文献类型：
--
作者：
Miller, MR;Gergen, P;Zhan, CL
上下文。-儿童保健质量的衡量标准不像成人那样完善。目前还不清楚的是，目前的一系列措施在多大程度上解决了儿童疾病和保健利用的常见原因。-本研究的目的是根据不同的有利位置来定义相对于儿童住院和门诊护理的负担，为儿童创建高优先级条件列表。然后将这些高优先级条件与所有已知的现有儿科卫生保健质量测量数据交叉制表。通过使用2000年全国门诊医疗调查、2000年全国医院门诊医疗调查、1999年医疗支出小组调查、2000年医疗保健成本和利用项目的国家住院病人数据库和2000年医疗保健成本和利用项目的国家门诊手术数据库，确定了儿童的高患病率状况。使用就诊频率、收费、院内死亡进行负担评估。现有的儿童质量措施是根据最近的这些措施汇编和对国家质量措施信息交换所的搜索确定的。-与住院和门诊环境中的高负担条件相比，现有的儿童保健质量措施存在许多巨大差距。随着衡量甚至公开报告卫生保健的努力不断增加，为儿童所做的努力需要包括侧重于针对儿童所经历的高负担状况建立具有代表性的质量措施。
Context.-Measures of health care quality for children are not as well developed as those for adults. It is also unclear the extent to which the current pool of measures address common causes of illness and health care utilization for children.Objective.-The goal of this study was to create lists of high-priority conditions for children based on different vantage points for defining burden relative to both inpatient and outpatient care for children. These high-priority conditions were then cross-tabulated with all known existing quality measures for pediatric health care.Data.-High-prevalence conditions for children were identified by using the 2000 National Ambulatory Medical Care Survey, 2000 National Hospital Ambulatory Medical Care Survey, 1999 Medical Expenditure Panel Survey, 2000 Healthcare Cost and Utilization Project's State Inpatient Databases, and 2000 Healthcare Cost and Utilization Project's State Ambulatory Surgery Databases. Burden assessments were done using frequencies of visits, charges, in-hospital deaths. Existing quality measures for children were identified from a recent compendium of such measures and a search of the National Quality Measures Clearinghouse.Results.-There are numerous and large gaps in existing quality-of-care measures for children relative to high-burden conditions in both the inpatient and outpatient setting. With the ever increasing efforts to measure and even publicly report on health care, efforts for children need to include focus on building a representative repertoire of quality measures for the high-burden conditions children experience.