title: Patient reported outcomes as indicators of pediatric health care quality.
abstract: Health care reform has increased demand for pediatric health care quality evaluations, particularly those that assess the impact of care on patient and population health outcomes. Many of today's most common childhood conditions are characterized by symptoms, behaviors, and functional limitations that are best assessed as patient reported outcomes (PROs). Although they remain greatly underutilized, PROs have the potential to improve pediatric health care quality assessment at the point of care and through system-level performance evaluations. The functions, benefits, and challenges of these PRO applications are described and illustrated in case examples. Although challenges remain, numerous methodological and technical innovations facilitate the use of PROs as health care quality metrics. These include advances in PRO measure development methodologies, the integration of PRO measures into electronic health records, and developing consensus among providers that PROs provide valuable information that can be used to enhance patient care. Although additional work is needed to address remaining methodological challenges, pediatric PROs are increasingly recognized as valuable indicators of health care quality in the clinical environment and as measures of organization- and provider-level performance.
authors.affiliation: Department of Pediatrics, Children's Hospital of Philadelphia and the University of Pennsylvania School of Medicine, Philadelphia, Pa. Electronic address: bevans@e-mail.chop.edu.
authors.forename: Katherine B
authors.initials: KB
authors.lastname: Bevans
authors.affiliation: Department of General Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pa.
authors.forename: JeanHee
authors.initials: J
authors.lastname: Moon
authors.affiliation: Department of Pediatrics, James M. Anderson Center for Health Systems Excellence, University of Cincinnati College of Medicine, and Department of Psychology, University of Cincinnati College of Arts and Sciences, Cincinnati, Ohio.
authors.forename: Adam C
authors.initials: AC
authors.lastname: Carle
authors.affiliation: James M. Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
authors.forename: Constance A
authors.initials: CA
authors.lastname: Mara
authors.affiliation: Medical Social Sciences and Pediatrics, Northwestern University, Chicago, Ill.
authors.forename: Jin-Shei
authors.initials: JS
authors.lastname: Lai
authors.affiliation: Center for Healthcare Studies, Northwestern Feinberg School of Medicine, Northwestern University, Chicago, Ill.
authors.forename: Lindsay
authors.initials: L
authors.lastname: DiMarco
authors.affiliation: Center for Healthcare Studies, Northwestern Feinberg School of Medicine, Northwestern University, Chicago, Ill.
authors.forename: Nicole
authors.initials: N
authors.lastname: Muller
authors.affiliation: Graduate Programs in Healthcare Quality and Patient Safety and the Northwestern Program for Quality and Safety Innovation, Center for Healthcare Studies, Feinberg School of Medicine, Northwestern University, Chicago, Ill.
authors.forename: Donna
authors.initials: D
authors.lastname: Woods
mesh_terms: D002648:Child; D003625:Data Collection / Q000379:methods; D006801:Humans; D063868:Patient Outcome Assessment; D017060:Patient Satisfaction; D010372:Pediatrics / Q000592:standards*; D019984:Quality Indicators, Health Care; D057566:Self Report; D014481:United States
keywords: health care quality; patient reported outcomes; pediatric