美国儿童行为健康质量措施:推进国家研究议程。

IF 3.6
Bonnie T Zima
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引用次数: 2

摘要

这篇论文是基于在加州洛杉矶举行的国际儿童和青少年精神病理学研究学会(ISRCAP)两年一次会议的主题演讲。有目的地选择这一主题是为了提高人们的认识,即在国家层面上对儿童行为保健质量的测量以及相应的信度和临床效度标准与传统上用于儿童精神病理学测量的标准有多大不同。在联邦政府的授权下,一套针对儿童质量的初步核心措施由各州医疗补助机构自愿报告。2019年儿童核心标准中的四项国家儿童行为健康质量措施包括护理的及时性,因儿童年龄范围而异,以及两种不同类型的精神药物治疗。描述了措施,并提供了对数据解释的影响。研究结果总结如下:1)系统的文献综述;2)国家参保率;3)按健康计划类型划分的十年全国参保率趋势。支持这些措施临床有效性的科学证据很少,各州的依从率差异很大,而且随着时间的推移,改善幅度不大。然而,州医疗补助机构将被授权从2024年开始报告衡量依从率。综上所述,这些发现激发了对卫生政策的建议,以便为数据基础设施分配额外资源,以监测儿童精神卫生保健质量,并确定未来研究的领域。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
U.S. Child Behavioral Health Quality Measures: Advancing a National Research Agenda.

This paper is based on the keynote presentation for the biennial meeting of the International Society for Research on Child and Adolescent Psychopathology (ISRCAP) in Los Angeles, California. The topic was purposively selected to raise awareness of how the measurement of child behavioral health care quality at the national level, and corresponding standards for reliability and clinical validity, substantially differ from those traditionally applied to the measurement of child psychopathology. Under a federal mandate, an initial Core Set of quality measures for children was created for voluntary reporting by State Medicaid agencies. The four national child behavioral health quality measures in the 2019 Child Core Set encompass timeliness of care, vary by child age range, and two different types of psychotropic medication treatments. Measures are described and implications for data interpretation are provided. Findings are summarized from: 1) a systematic literature review; 2) State adherence rates; and 3) ten-year national trends in adherence rates by health plan type. Scientific evidence supporting the clinical validity of the measures is scarce, statewide adherence rates widely vary, and improvement over time has been modest. Nevertheless, State Medicaid agencies will be mandated to report measure adherence rates beginning in 2024. Together, these findings stimulate recommendations for health policies to allocate additional resources for data infrastructure to monitor child mental health care quality and identify areas for future research.

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来源期刊
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期刊介绍: Research on Child and Adolescent Psychopathology brings together the latest innovative research that advances knowledge of psychopathology from infancy through adolescence. The journal publishes studies that have a strong theoretical framework and use a diversity of methods, with an emphasis on empirical studies of the major forms of psychopathology found in childhood disorders (e.g., disruptive behavior disorders, depression, anxiety, and autism spectrum disorder). Studies focus on the epidemiology, etiology, assessment, treatment, prognosis, and developmental course of these forms of psychopathology. Studies highlighting risk and protective factors; the ecology and correlates of children''s emotional, social, and behavior problems; and advances in prevention and treatment are featured. Research on Child and Adolescent Psychopathology is the official journal of the International Society for Research in Child and Adolescent Psychopathology (ISRCAP), a multidisciplinary scientific society.
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