Homer C J, Fowler F J, Gallagher P M, Shaul J, Uyeda M, Zaslavsky A, Wilson V, Cleary P
Harvard Medical School, Boston, USA.
Jt Comm J Qual Improv. 1999 Jul;25(7):369-77. doi: 10.1016/s1070-3241(16)30452-7.
Little is known about the experience of children and families with pediatric care. Asking parents about their experiences and the treatment of their children in health care plans can yield important information about selected aspects of medical care quality. Such data can be used to motivate, focus, and evaluate quality improvement efforts.
Development of the Child Core Survey followed the survey development principles of the Consumer Assessment of Health Plan Study (CAHPS) project, starting with assembly of existing instruments, consultation with experts, focus groups, and cognitive testing. A field test of the survey was conducted by mail among members enrolled in 1 of 25 plans originally identified as providing health care services to the public employees of the state of Washington (response rate, 52%).
The 3,083 respondents rated personal doctors most highly, with overall care and specialty care rated nearly as well, and plan administration rated lowest. Parent-clinician and child-clinician communication, as well as spending sufficient time with the child were the strongest correlates of assessments of overall care and of personal doctors. Plans differed significantly in their performance along all the dimensions of child health care assessed in the survey except for aspects of access ("getting the care you need").
The Child Core Survey from the CAHPS provides a readily accessible method to assess the interpersonal care of children. Such data could be used to make plans accountable to the needs of children, to focus specific improvement initiatives, or both.
关于儿童及其家庭接受儿科护理的经历，我们知之甚少。询问父母他们在医疗保健计划中的经历以及孩子的治疗情况，可以获得有关医疗护理质量某些方面的重要信息。这些数据可用于激励、聚焦和评估质量改进工作。
儿童核心调查问卷的开发遵循了消费者健康计划评估研究（CAHPS）项目的调查问卷开发原则，首先是整合现有工具、咨询专家、进行焦点小组讨论和认知测试。通过邮件对最初确定为向华盛顿州公职人员提供医疗保健服务的25个计划中的1个计划的成员进行了该调查问卷的现场测试（回复率为52%）。
3083名受访者对私人医生的评价最高，对整体护理和专科护理的评价也几乎相同，而对计划管理的评价最低。家长与临床医生以及孩子与临床医生之间的沟通，以及与孩子共度足够的时间，是对整体护理和私人医生评价的最强相关因素。在调查评估的儿童医疗保健的所有维度上，除了就医机会方面（“获得所需的护理”），各计划的表现存在显著差异。
CAHPS的儿童核心调查问卷提供了一种易于获取的方法来评估儿童的人际护理。这些数据可用于使计划对儿童的需求负责，聚焦特定的改进举措，或两者兼而有之。
