Identifying Threshold Levels of Structural and Process Quality

确定结构和过程质量的阈值水平

基本信息

批准号：
7591056
负责人：
Vi-Nhuan Le
金额：
$ 9.14万
依托单位：
RAND CORPORATION
依托单位国家：
美国
项目类别：
财政年份：
2008
资助国家：
美国
起止时间：
2008-04-01 至 2011-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7591056
关键词：
2 year old Academy Address Adopted Age American American Public Health Association Birth Caring Characteristics Child Child Care Child Development Cognitive Consensus Data Data Set Development Dimensions Education Employment Enrollment Hand Health Home environment Institute of Medicine (U.S.)Investments Joints Language Development Learning Literature Longitudinal Studies Love Measures Monitor National Institute of Child Health and Human Development National Research Council Outcome Outcome Measure Outcome Study Pediatrics Policies Process Provider Quality Indicator Quality of Care Reporting Research Statistical Methods System Training and Education cognitive function cohort cost early childhood emotional adjustment experience improved meetings parental involvement physical conditioning programs social social skills statistics teacher

项目摘要

DESCRIPTION (provided by applicant): The cumulative evidence of research on early childhood care and children's development consistently finds that higher-quality care is predictive of a range of positive developmental outcomes for children, including improved language development, cognitive functioning, social competence, and emotional adjustment. This has led many states to attempt to improve the availability of high quality early childhood care through a tiered quality rating system. Under this system, states define thresholds or cut-off points across various dimensions of quality, and provide different amounts of reimbursement to providers depending on their compliance with the quality standards. The literature provides little guidance to state policymakers as to where the thresholds should be set, as few studies have identified the specific cut off points or thresholds that can distinguish among different levels of child outcomes. Thus, it is unknown whether the cut off points established by state policymakers actually discriminate among better and worse child outcomes. This can raise fairness questions if providers receive different amounts of reimbursement for implementing different levels of quality, yet there are no differences in child outcomes. The purpose of this study is to provide some guidance to state policymakers about potentially optimal cut off points by using advanced statistical methods to identify the thresholds that must be exceeded before significant differences in child outcomes can be observed between providers that meet the established quality standards and providers that do not. It will also identify the points at which there are diminishing returns in quality investments. We will use data from the Cost, Quality, and Outcomes Study and the Early Childhood Longitudinal Study Birth Cohort through 2 years old, Restricted Use to examine threshold effects. We will examine various quality indicators, such as staff education and training, childstaff ratios, group size (i.e., the number of children in the class), ECERS/ITERS, and parental involvement. Children's social, cognitive, and physical health outcomes will serve as the outcome measures. The results of the study will give policymakers a better indication of which specific cut off points discriminate among different levels of child outcomes. This will help inform sensible approaches to differential reimbursement strategies.

描述（由申请人提供）：关于幼儿护理和儿童发展的研究的累积证据始终发现，高质量的护理可以预测儿童的一系列积极发展成果，包括改善语言发展，认知功能，社会能力和情感调整。这导致许多州试图通过分层的评级系统来改善高质量的幼儿护理。在此系统下，各州定义了质量各个方面的阈值或截止点，并根据其符合质量标准的规定向提供商提供不同数量的报销。文献对国家决策者就应设定阈值设定的位置提供了很少的指导，因为很少有研究确定了可以区分不同儿童结果的特定切断点或阈值。因此，尚不清楚国家政策制定者确定的切断点是否在更好和更差的儿童结局中歧视。如果提供者获得不同数量的报销来实施不同水平的质量，那么这可能会提出公平的问题，但儿童结局没有差异。这项研究的目的是通过使用先进的统计方法来确定在符合确定既定质量标准标准的提供者之间，通过使用先进的阈值来确定必须超过儿童结果之前必须超过的阈值，以向国家决策者提供一些指导，以确定必须超过阈值。它还将确定优质投资回报率降低的点。我们将使用来自成本，质量和结果研究的数据以及2年历史的幼儿纵向研究出生队列，以检查阈值效应。我们将检查各种质量指标，例如员工教育和培训，孩子的比例，小组规模（即班上的儿童人数），ECERS/ITERS和父母的参与。儿童的社会，认知和身体健康成果将作为结果措施。该研究的结果将使决策者更好地表明哪些特定切断点可以区分不同水平的儿童结局。这将有助于为差额报销策略提供明智的方法。