Hospitalized children represent an important segment of the medical patient population. In 2000, children accounted for 18 percent or 6.3 million of the hospitalizations in the United States. With the growing interest in quality of care, quality measurement sets have proliferated. However, most of these measurement systems have focused on adults rather than children. Many of the diseases or outcomes that are measured are not common in children or present or progress differently in the pediatric population. Also, children differ from adults in important ways: for example, children are generally healthier, rarely hospitalized (except in complex cases), continuously developing, and are dependent on adults for care. These differences imply that measures of quality care designed for adults are not easily applied to children. Those quality measures that have been designed specifically for children tend to focus on the largest sector of pediatric care -- well-child and outpatient care -- leaving few indicators that explicitly measure care for hospitalized children.
From 1998 to 2002, Stanford University and the University of California, under contract with the Agency of Healthcare Research and Quality (AHRQ), developed the AHRQ Quality Indicators (QIs), which consist of the Inpatient Quality Indicators, Patient Safety Indicators, and the Prevention Quality Indicators. A few pediatric indicators were included in these measure sets, but users found the application of the AHRQ QIs to pediatric populations to be inadequate to develop an accurate and comprehensive picture of care and requested additional indicators.
In response, AHRQ contracted with Stanford University, University of California at Davis, and Battelle Memorial Institute, to develop a set of indicators, to be named the Pediatric Quality Indicators (PedQI). This project -- a part of the Support for Quality Indicators project – occurred in two phases. The first phase, completed in February 2006, assessed the applicability of the current AHRQ QIs to a pediatric population, and produced a set of adapted Pediatric Quality Indicators. The second phase added several neonatal indicators to the PedQI.
For further information about ongoing work at Stanford on the pediatric indicators and other AHRQ quality and patient safety indicators, see the AHRQ Quality Indicators Enhancement project at http://healthpolicy.fsi.stanford.edu/research/ahrq-quality-indicators-enhancement