Herndon Jill Boylston, Crall James J, Aravamudhan Krishna, Catalanotto Frank A, Huang I-Chan, Rudner Nancy, Tomar Scott L, Shenkman Elizabeth A
Department of Health Outcomes and Policy, Institute for Child Health Policy, University of Florida College of Medicine, Gainesville, FL, USA.
Division of Public Health and Community Dentistry, UCLA School of Dentistry, Los Angeles, CA, USA.
J Public Health Dent. 2015 Summer;75(3):191-201. doi: 10.1111/jphd.12087. Epub 2015 Feb 13.
This study describes processes used to develop and test pediatric oral healthcare quality measures and provides recommendations for implementation.
At the request of the Centers for Medicare and Medicaid Services, the Dental Quality Alliance (DQA) was formed in 2008 as a multi-stakeholder group to develop oral healthcare quality measures. For its initial focus on pediatric care, measure development processes included a literature review and environmental scan to identify relevant measure concepts, which were rated on importance, feasibility, and validity using the RAND/UCLA modified Delphi approach. These measure concepts and a gap assessment led to the development of a proposed set of measures that were tested for feasibility, reliability, and validity.
Of 112 measure concepts identified, 59 met inclusion criteria to undergo formal rating. Twenty-one of 59 measure concepts were rated as "high scoring." Subsequently, 11 quality and related care delivery measures comprising a proposed pediatric starter set were developed and tested; 10 measures met feasibility, reliability, and validity criteria and were approved by the DQA stakeholder membership. These measures are currently being incorporated into Medicaid, Children's Health Insurance Program, and commercial quality improvement programs.
Broad stakeholder engagement, rigorous measure development and testing processes, and regular opportunities for public input contributed to the development and validation of the first set of fully specified and tested pediatric oral healthcare quality measures, which have high feasibility for implementation in both public and private sectors. This achievement marks an important essential step toward improving oral healthcare and oral health outcomes for children.
本研究描述了用于制定和测试儿科口腔保健质量指标的过程，并提供实施建议。
应医疗保险和医疗补助服务中心的要求，牙科质量联盟（DQA）于2008年成立，作为一个多利益相关方团体来制定口腔保健质量指标。其最初专注于儿科护理，指标制定过程包括文献综述和环境扫描，以确定相关的指标概念，并使用兰德/加州大学洛杉矶分校改良德尔菲法对这些概念在重要性、可行性和有效性方面进行评级。这些指标概念和差距评估导致了一套拟议指标的制定，并对其可行性、可靠性和有效性进行了测试。
在确定的112个指标概念中，59个符合纳入标准，可进行正式评级。59个指标概念中有21个被评为“高分”。随后，制定并测试了11项质量和相关护理提供指标，构成一套拟议的儿科起始指标集；10项指标符合可行性、可靠性和有效性标准，并得到了DQA利益相关方成员的批准。这些指标目前正被纳入医疗补助、儿童健康保险计划和商业质量改进计划中。
广泛的利益相关方参与、严格的指标制定和测试过程以及定期的公众参与机会，促成了第一套完全明确且经过测试的儿科口腔保健质量指标的制定和验证，这些指标在公共和私营部门实施的可行性都很高。这一成果标志着朝着改善儿童口腔保健和口腔健康结果迈出了重要的关键一步。
