MEASURING QUALITY OF CARE FOR VULNERABLE CHILDREN

利用一个单一的机会，本研究的目的是验证现有的儿科健康相关的生活质量（HRQOL）的工具作为一个结果的衡量护理质量的弱势儿童。 作为一个正在进行的学校健康倡议的评估小组，调查人员可以访问该项目的整个范围的结构，过程和结果数据。 这一倡议，健康链接，是一个独特的公共/私人伙伴关系之间的第8大城市学区在全国，第4大人口最多的县在全国，和当地的医疗保健提供者改变医疗服务的方式提供给弱势儿童。 HealthLink的既定目标是“通过改善圣地亚哥联合学区（SDUSD）学生的健康状况来提高他们的学习成绩。“HealthLink在其规模（SDUSD的140，000名学生），范围（由150多名专业人员组成的八个工作队，代表数千人小时的工作）以及它从学区负责人，县卫生和人类服务局（SDHHSA）负责人以及主要社区卫生服务提供者的首席执行官那里获得的支持方面是独一无二的。 SDUSD服务的140，000名学生因其年龄、少数民族和贫困状况、有限的英语能力和医疗保险覆盖率而成为弱势群体。 保健联系的主要干预措施是将每个学生与医疗之家联系起来，加强学校护士与保健提供者之间的医疗联络，消除影响上学的主要保健和社会障碍，并加强以学校为基础和与学校联系的保健服务。 在这一变化的背景下，作为HealthLink的评价组，研究者将使用经验证的儿科HRQOL指标PedsQLTM评估和监测这些儿童的HRQOL。将根据作为HealthLink一部分收集的结构、过程和结局数据分析PedsQL？评分，以检查PedsQL？评估护理质量变化和变化的能力。具体目标是：1）通过检查PedsQLTM与结构、过程之间的关系以及时间内和跨时间的护理结果，现场测试PedsQLTM作为护理质量的结果指标; 2）将PedsQLTM翻译为阈值语言，如Tagsal和越南语（PedsQLTM已翻译为西班牙语）。 一个有效的儿科卫生服务质量的结果测量可以用于购买或改善卫生保健服务，并证明社区必须做什么，以提供高质量的卫生保健，他们的孩子。

Taking advantage of a singular opportunity, this research aims to validate an existing pediatric health-related quality of life (HRQOL) instrument as an outcome measure of quality of care for vulnerable children. As the evaluation team for an ongoing school health initiative, the investigators have access to structure, process, and outcomes data for the full scope of this project. This initiative, HealthLink, is a unique public/private partnership between the 8th largest urban school district in the nation, the 4th most populated county in the nation, and local health care providers to change the way health services are delivered to vulnerable children. HealthLink's stated goal is to "improve the student achievement of San Diego Unified School District (SDUSD) students by improving their health status." HealthLink is unique in its size (140,000 students in SDUSD), in its scope (eight task forces comprised of over 150 professionals, representing thousands of person-hours of work), and in the support it enjoys from the Superintendent of the school district, the head of the County's Health and Human Services Agency (SDHHSA), and from the CEO's of the major community health providers. The 140,000 students served by SDUSD represent a vulnerable population by virtue of their age, minority and poverty status, limited English proficiency, and rate of health insurance coverage. The main HealthLink interventions are to link every student with a medical home, enhance medical liaison between school nurses and health care providers, address the major health and social barriers to attendance, and enhance school-based and school-linked health services. In the context of this change, and as HealthLink's evaluative arm, the investigators will assess and monitor the HRQOL of these children using a validated pediatric HRQOL measure, the PedsQLTM. PedsQLTM scores will be analyzed in relation to structure, process, and outcomes data collected as part of HealthLink, in order to examine the ability of the PedsQLTM to assess variation in, and changes to, quality of care. Specific aims are: 1) to field test the PedsQLTM as an outcome indicator of quality of care by examining the relationship between the PedsQLTM and structures, processes, and outcomes of care within and across time and 2) to translate the PedsQLTM to threshold languages such as Tagalog and Vietnamese (the PedsQLTM has been translated to Spanish). A validated outcome measure of quality of pediatric health services can be used in the purchase or improvement of health care services and to demonstrate what communities must do in order to provide high-quality health care to their children.