PT  - JOURNAL ARTICLE
AU  - Allison Casciato
AU  - Heather Angier
AU  - Christina Milano
AU  - Nicholas Gideonse
AU  - Rachel Gold
AU  - Jennifer DeVoe
TI  - Are Pediatric Quality Care Measures Too Stringent?
AID  - 10.3122/jabfm.2012.05.120041
DP  - 2012 Sep 01
TA  - The Journal of the American Board of Family
                Medicine
PG  - 686--693
VI  - 25
IP  - 5
4099  - http://www.jabfm.org/content/25/5/686.short
4100  - http://www.jabfm.org/content/25/5/686.full
SO  - J Am Board Fam Med2012 Sep 01; 25
AB  - Introduction: We aimed to demonstrate the application of national pediatric quality measures, derived from claims-based data, for use with electronic medical record data, and determine the extent to which rates differ if specifications were modified to allow for flexibility in measuring receipt of care. Methods: We reviewed electronic medical record data for all patients up to 15 years of age with ≥1 office visit to a safety net family medicine clinic in 2010 (n = 1544). We assessed rates of appropriate well-child visits, immunizations, and body mass index (BMI) documentation, defined strictly by national guidelines versus by guidelines with clinically relevant modifications. Results: Among children aged <3 years, 52.4% attended ≥6 well-child visits by the age of 15 months; 60.8% had ≥6 visits by age 2 years. Less than 10% completed 10 vaccination series before their second birthday; with modifications, 36% were up to date. Among children aged 3 to 15 years, 63% had a BMI percentile recorded; 91% had BMI recorded within 36 months of the measurement year. Conclusions: Applying relevant modifications to national quality measure definitions captured a substantial number of additional services. Strict adherence to measure definitions might miss the true quality of care provided, especially among populations that may have sporadic patterns of care utilization.