Center of Excellence on Quality of Care Measures for Children with Complex Needs

描述(由申请人提供)：与儿童相关的研究和政策侧重于扩大公共保险计划的资格，但扩大对不提供必要服务的系统的准入将不会产生最佳结果。如果要制定和实施缩小差距的适当战略，就必须查明提供护理的不足之处。儿童健康保险计划重新授权法案(CHIPRA)第四章要求美国卫生与公众服务部部长确定并发布一套初步的、推荐的儿童健康护理质量衡量标准，供医疗补助和儿童健康保险计划(CHIP)自愿使用，并征求公众意见。虽然这套最初的核心措施是一个良好的起点，但这只是制定一套严格、标准化的措施的长期进程的第一步，这些措施将促进例行质量评估和指导改善儿童医疗质量的优先事项。在选择CHIPRA立法规定的一套初始核心措施时，查明了若干不足之处。这些问题包括缺乏针对特定类型护理和护理环境的措施，以及无法充分收集关于种族、族裔和特殊卫生保健需求状况的数据，以监测护理方面的差异和差异。此外，没有确定评估“最综合的医疗保健环境”的质量指标。为了这个项目，我们组建了一个复杂需求儿童护理质量措施英才中心(COE4CCN)。COE4CCN汇集了一群不同的、有才华的组织和个人，他们拥有专业知识和能力，能够严格制定和测试解决上述所有赤字领域的质量措施。COE4CCN包括以下领域的专家：调查措施的制定、使用医疗记录和/或行政数据的循证程序措施的制定、风险调整、评估差异，以及适当地识别有特殊卫生保健需要的儿童并将其划分为有意义的风险类别。此外，COE4CCN汇集了几个关键领域的内容专家，包括医疗之家、CSHCN护理、儿童和青少年心理和行为健康、青少年慢性病管理、种族/民族差异和健康信息学。几个关键的利益相关者团体也将是COE4CCN的不可或缺的成员，包括来自两个州(西澳和明尼苏达州)的医疗补助和CHIP计划的代表，来自西澳和明尼苏达州AAP分会的代表，以及来自MN家庭之声的代表。COE4CCN将有能力制定有意义的、严格设计的、可传播的质量衡量标准，可在国家一级用于跟踪和改进向美国儿童提供的护理质量。

DESCRIPTION (provided by applicant): Research and policy related to children has focused on expanding eligibility for public insurance programs, but expanding access to a system that does not deliver necessary services will not result in optimal outcomes. Deficits in care delivery must be identified if appropriate strategies to close the gaps are to be developed and implemented. Title IV of the Child Health Insurance Program Reauthorization Act (CHIPRA) called for the Secretary of the U.S. Department of Health and Human Services to identify and post for public comment an initial, recommended core set of children's health care quality measures for voluntary use by Medicaid and Children's Health Insurance Programs (CHIP). While this initial core set of measures represents a good starting place, it is just the first step in a long term process to develop a rigorous, standardized set of measures that will facilitate routine quality assessment and guidance on priorities for improving children's healthcare quality. Several deficits were identified during the selection of the initial core set of measures mandated by the CHIPRA legislation. These included a dearth of measures for particular types of care and care settings as well as an inability to adequately collect data on race, ethnicity, and special health care need status to monitor variations in care and disparities. Additionally, no quality measures were identified that assess "most integrated health care settings." For this project we have assembled a Center of Excellence on Quality of Care Measures for Children with Complex Needs (COE4CCN). The COE4CCN brings together a diverse and talented group of organizations and individuals who have the expertise and capacity to rigorously develop and test quality measures that address all of the above mentioned areas of deficit. The COE4CCN includes experts in the areas of survey measure development, evidence-based process measure development using medical records and/or administrative data, risk adjustment, assessing disparities, and appropriately identifying and stratifying children with special health care needs into meaningful risk categories. Additionally, the COE4CCN brings together content experts in several key areas including the medical home, caring for CSHCN, child and adolescent mental and behavioral health, chronic disease management in adolescents, racial/ethnic disparities, and health informatics. Several key stakeholder groups will also be integral members of the COE4CCN, including representatives from Medicaid and CHIP programs in two states (WA and MN), representatives from the AAP Chapters in WA and MN, and representatives from MN Family Voices. The COE4CCN will have the ability to develop meaningful, rigorously designed, disseminable quality measures that can be used at the national level to both track and improve on the quality of care provided to US children.