The Conundrum of Measuring Children’s Primary Health Care

I. Rocco, Barbara Corso, D. Luzi, F. Pecoraro, Oscar Tamburis, U. Hoang, H. Liyanage, F. Ferreira, S. de Lusignan, N. Minicuci
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引用次数: 2

Abstract

Abstract Evaluating primary care for children has not before been undertaken on a national level, and only infrequently on an international level, an adult-focused perspective is the norm. The Models of Child Health Appraised (MOCHA) project explored the evaluation of quality of primary care for children in a nationally comparable way, which recognises the influence of all components of child well-being and well-becoming. Using adult-focused metrics fails to account for children’s physical and psycho-social development at different ages, differences in health and non-health determinants, patterns of disease and risk factors and the stages of the life course. To do this, we attempted to identify comparable measures of child health in the European Union and European Economic Area countries, we aimed to perform a structural equation modelling technique to identify causal effects of certain policies or procedures in children’s primary care and we aimed to identify and interrogate large datasets for key tracer conditions. We found that the creation of comparative data for children and child health services remains a low priority in Europe, and the largely unmet need for indicators covering all the healthcare dimensions hampers development of evidence-based policy. In terms of the MOCHA project objective of appraising models of child primary health care, the results of this specific work show that the means of appraisal of system and service quality are not yet agreed or mature, as well as having inadequate data to fuel them.
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衡量儿童初级卫生保健的难题
评估儿童的初级保健以前没有在国家层面上进行,只有在国际层面上很少进行,以成人为中心的观点是规范。儿童健康评估模式(MOCHA)项目探索了以全国可比方式评估儿童初级保健质量的方法,该方法认识到儿童福利和福祉的所有组成部分的影响。使用以成人为重点的指标不能考虑到儿童在不同年龄的身体和心理社会发展、健康和非健康决定因素的差异、疾病和风险因素的模式以及生命历程的各个阶段。为此,我们试图确定欧盟和欧洲经济区国家儿童健康的可比指标,我们的目标是执行结构方程建模技术,以确定儿童初级保健中某些政策或程序的因果效应,我们的目标是确定和询问关键示踪条件的大型数据集。我们发现,在欧洲,建立儿童和儿童保健服务的比较数据仍然不是一个优先事项,而且对涵盖所有保健方面的指标的需求在很大程度上没有得到满足,这阻碍了循证政策的发展。就MOCHA儿童初级卫生保健模式评价的项目目标而言,该具体工作的结果表明,系统和服务质量的评价手段尚未达成一致或成熟,并且缺乏足够的数据支持。
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