Rural Clinician Evaluation of Children's Health Care Quality Measures: An Oregon Rural Practice-based Research Network (ORPRN) Study.
BACKGROUND
Responding to quality metrics is an accepted and expected component of the current health care environment. Little is known about which measures physicians identify as a priority when reporting the quality of care to their patients, especially the care of children in rural settings. The objective of this study is for physicians caring for children in rural communities to identify which of the initial core sets of 24 child health quality measures are useful and are a priority for reporting and improving care.


METHODS
A survey was sent to rural Oregon physicians who provide care to children.


RESULTS
Of 955 eligible physicians, 172 (18%) completed the survey. The majority of respondents were family physicians (84%), and most respondents (58%) were in private practice. The child health measures stratified into 3 priority tiers: high, medium, and low priority. The top-tier priority measures included childhood immunization status, well-child visits, adolescent immunization status, body mass index assessment, and developmental screening. Dental treatment services, adequate prenatal care, and lower-birth-weight infants were among the lower-tier measures.


CONCLUSIONS
The priority measures identified by rural family physicians reflect the relevance of the selected measures to their daily practice responsibilities, with missed opportunities to improve community health.
From the Oregon Rural Practice-based Research Network, Oregon Health & Science University, Portland (LJF, LM, KR, SS); the Department of Family Medicine, Oregon Health & Science University, Portland (LJF); the Department of Public Health and Preventive Medicine, Oregon Health & Science University, Portland (KR); and the Office of Health Analytics, Oregon Health Authority, Salem (OD, CG). fagnanl@ohsu.edu.
Lyle J
LJ
Fagnan
From the Oregon Rural Practice-based Research Network, Oregon Health & Science University, Portland (LJF, LM, KR, SS); the Department of Family Medicine, Oregon Health & Science University, Portland (LJF); the Department of Public Health and Preventive Medicine, Oregon Health & Science University, Portland (KR); and the Office of Health Analytics, Oregon Health Authority, Salem (OD, CG).
LeAnn
L
Michaels
From the Oregon Rural Practice-based Research Network, Oregon Health & Science University, Portland (LJF, LM, KR, SS); the Department of Family Medicine, Oregon Health & Science University, Portland (LJF); the Department of Public Health and Preventive Medicine, Oregon Health & Science University, Portland (KR); and the Office of Health Analytics, Oregon Health Authority, Salem (OD, CG).
Katrina
K
Ramsey
From the Oregon Rural Practice-based Research Network, Oregon Health & Science University, Portland (LJF, LM, KR, SS); the Department of Family Medicine, Oregon Health & Science University, Portland (LJF); the Department of Public Health and Preventive Medicine, Oregon Health & Science University, Portland (KR); and the Office of Health Analytics, Oregon Health Authority, Salem (OD, CG).
Stefan
S
Shearer
From the Oregon Rural Practice-based Research Network, Oregon Health & Science University, Portland (LJF, LM, KR, SS); the Department of Family Medicine, Oregon Health & Science University, Portland (LJF); the Department of Public Health and Preventive Medicine, Oregon Health & Science University, Portland (KR); and the Office of Health Analytics, Oregon Health Authority, Salem (OD, CG).
Oliver
O
Droppers
From the Oregon Rural Practice-based Research Network, Oregon Health & Science University, Portland (LJF, LM, KR, SS); the Department of Family Medicine, Oregon Health & Science University, Portland (LJF); the Department of Public Health and Preventive Medicine, Oregon Health & Science University, Portland (KR); and the Office of Health Analytics, Oregon Health Authority, Salem (OD, CG).
Charles
C
Gallia
D000293:Adolescent; D002648:Child; D000067576:Child Health; D002983:Clinical Competence; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D009922:Oregon; D010821:Physicians, Family / Q000592:standards*; D011320:Primary Health Care / Q000592:standards*; D011787:Quality of Health Care; D012423:Rural Health; D019035:Rural Health Services / Q000592:standards*
Child Health; Practice-based Research Network; Primary Health Care; Quality Improvement; Rural Health