Established Child Health Care Quality Measures
Quality measures are used by public programs serving children, including Medicaid, the State Children's Health Insurance Program (SCHIP), and Title V of the Social Security Act, and by private sector entities. This section describes several existing measurement sets.
CAHPS® (pronounced "caps"): CAHPS®, formerly known as Consumer Assessment of Health Plans, is a registered trademark of the Agency for Healthcare Research and Quality. It is a survey instrument that measures perceptions of the experience of health care. Responses for children are provided by parents or guardians.
- Online Resource: For more information on CAHPS®, go to: http://www.ahrq.gov/chtoolbx/measure2.htm
AHRQ QIs (pronounced "Arc Q.I.s"): AHRQ Quality Indicators. These measures are derived from hospital discharge data and can provide warnings about the existence of potentially inadequate care.
- Online Resource: For more information on AHRQ QIs, go to: http://www.ahrq.gov/chtoolbx/measure3.htm
HEDIS® (pronounced "HEE-diss"): Health Plan Employer Data and Information Set. HEDIS® is a registered trademark of the National Committee for Quality Assurance. This performance measurement set contains measures of:
- Preventive and well care.
- Care for selected chronic conditions.
- Use of services.
- Perceptions of care (from CAHPS® 3.0H).
- Online Resource: For more information on HEDIS®, go to: http://www.ahrq.gov/chtoolbx/measure4.htm
Title V Maternal and Child Health Programs: This is a set of broadly defined performance and systems capacity measures particularly relevant for public health.
- Online Resource: For more information on Title V Maternal and Child Health Programs, go to: http://www.ahrq.gov/chtoolbx/measure5.htm
CAHMI Measures: Two measurement sets developed under the Child and Adolescent Health Measurement Initiative (CAHMI) assess the extent to which children and young adults receive recommended preventive and developmental health care:
- Promoting Healthy Development Survey (PHDS).
- Young Adult Health Care Survey (YAHCS).
- Online Resource: For more information on CAHMI, go to: http://www.ahrq.gov/chtoolbx/measure6.htm
For a quick snapshot of the types of measures discussed in this section, see the Child Health Care Quality Indicators at a Glance Matrix. Go to: http://www.ahrq.gov/chtoolbx/indicators.htm
Information on additional quality measures can be found in the section Emerging Measures. Go to: http://www.ahrq.gov/chtoolbx/emerging.htm
Information on 74 child health measures can also be found by searching the National Quality Measures Clearinghouse™ (NQMC), AHRQ's Web-based compendium of quality measures. Go to: http://www.qualitymeasures.ahrq.gov/
Information on measures developed by States and on the process of measure development can be found in the section Develop Your Own? Go to: http://www.ahrq.gov/chtoolbx/develop.htm.
Advantages of Using Established Measures
The process of quality measure development is resource intensive, time consuming, and exacting. It includes:
- Development of detailed specifications.
- Identification of complete and accurate data.
- Using proper sampling.
- Testing for reliability and validity.
- Field testing.
Online Resource: More information on quality measure development can be found in the section Develop Your Own? Go to: http://www.ahrq.gov/chtoolbx/develop.htm
When you use existing quality measures, this work has often been done for you. Existing quality measures typically include:
- Detailed definitions of key elements of the quality measure.
- Descriptions of what data are to be collected.
- Protocols for data collection and data analysis.
State maternal and child health (MCH) programs have been directed to develop their own State-negotiated MCH quality measures. Many other State agencies have chosen to use existing quality measures in order to benefit from the work of others and move more quickly to the actual stages of data collection and data analysis.
Other factors that States have found important when choosing quality measures include national databases of results that can be used as benchmarks for comparisons and the provision of user support programs.
Online Resource: For more information on choosing quality measures, go to: http://www.ahrq.gov/chtoolbx/choosing.htm
Quality Measures in State Reports
Research and experience alike have contributed to a growing base of knowledge concerning effective uses of quality measurement and reporting results. Many States have used quality measures in a variety of ways over a period of some years. Review of some State examples can give you:
- Ideas about what your colleagues have accomplished.
- Contacts for investigating what works and what doesn't.
Online Resource: For more information on State examples, go to: http://www.ahrq.gov/chtoolbx/measure8.htm