Health status of well vs ill adolescents.
BACKGROUND
Accountability of health services in meeting needs and assessing outcomes is hampered by the absence of tools to assess health, especially in children and youth. Because it is no longer adequate to assess health by a narrow focus on biological and physiological measures, instruments that assess functional status, person-focused general health status, and overall well-being in a more comprehensive way are needed.


OBJECTIVE
To examine whether a health status instrument we have developed discriminates between teenagers in schools and teenagers attending clinics for acute or chronic conditions.


METHODS
Teenagers (aged 11-17 years) in schools and in general medical and specialty clinics completed a questionnaire The Child Health and Illness Profile-Adolescent Edition (CHIP-AE), comprehensively covering aspects of health in 6 domains: discomfort, satisfaction with health, disorders, achievement of social expectations, risks, and resilience.


RESULTS
Acutely ill teenagers reported more physical discomfort, minor illnesses, and lower physical fitness; chronically ill teenagers reported more limitations of activity, long-term medical disorders, dissatisfaction with their health, and less physical fitness than teenagers in the school samples. Age, sex, and social class did not explain the differences. Teenagers within the acutely and chronically ill clinic populations differed substantially in their health status.


CONCLUSIONS
Availability of a comprehensive instrument (CHIP-AE) to assess adolescent health provides a means of documenting health needs and outcomes in populations of teenagers with acute or chronic illness. The heterogeneity within these groups provides support for a person-focused (rather than a disease-focused) approach to assessing both needs for care and the influence of care on promoting health.
Starfield
B
B
Department of Health Policy and Management, Johns Hopkins University School of Hygiene and Public Health, Baltimore, Md, USA.
Forrest
C B
CB
Ryan
S A
SA
Riley
A W
AW
Ensminger
M E
ME
Green
B F
BF
D000208:Acute Disease; D000293:Adolescent; D002648:Child; D002908:Chronic Disease; D016002:Discriminant Analysis; D006301:Health Services Needs and Demand; D006304:Health Status; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D010549:Personal Satisfaction; D010809:Physical Fitness; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires / Q000592:standards*