title: Development and Testing of thePediatricRespiratoryIllnessMeasurementSystem (PRIMES) Quality Indicators.
abstract: To develop and test quality indicators for assessing care in pediatric hospital settings for common respiratory illnesses.
  
  
  
  A sample of 2796 children discharged from the emergency department or inpatient setting at 1 of the 3 participating hospitals with a primary diagnosis of asthma, bronchiolitis, croup, or community-acquired pneumonia (CAP) between January 1, 2010, and December 31, 2011.
  
  
  
  Three tertiary care children's hospitals in the United States.
  
  
  
  We developed evidence-based quality indicators for asthma, bronchiolitis, croup, and CAP. Expert panel-endorsed indicators were included in thePediatricRespiratoryIllnessMeasurementSystem (PRIMES). This new set of pediatric quality measures was tested to assess feasibility of implementation and sensitivity to variations in care. Medical records data were extracted by trained abstractors. Quality measure scores (0-100 scale) were calculated by dividing the number of times indicated care was received by the number of eligible cases. Score differences within and between hospitals were determined by using the Student'st-test or analysis of variance.
  
  
  
  CAP and croup condition-level PRIMES scores demonstrated significant between-hospital variations (P< .001). Asthma and bronchiolitis condition-level PRIMES scores demonstrated significant within-hospital variation with emergency department scores (means [SD] 82.2(6.1)-100.0 (14.4)] exceeding inpatient scores (means [SD] 71.1 (2.0)-90.8 (1.3);P< .001).
  
  
  
  PRIMES is a new set of measures available for assessing the quality of hospital-based care for common pediatric respiratory illnesses.
authors.affiliation: Seattle Children Research Institute, Center for Child Health, Behavior and Development, Seattle, Washington; rita.mangione-smith@seattlechildrens.org.|Department of Pediatrics, University of Washington, Seattle, Washington.
authors.forename: Rita
authors.initials: R
authors.lastname: Mangione-Smith
authors.affiliation: RAND Corporation, Santa Monica, California.
authors.forename: Carol P
authors.initials: CP
authors.lastname: Roth
authors.affiliation: Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.|Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio.
authors.forename: Maria T
authors.initials: MT
authors.lastname: Britto
authors.affiliation: AltaMed Health Services, Los Angeles, California; and.
authors.forename: Alex Y
authors.initials: AY
authors.lastname: Chen
authors.affiliation: Seattle Children Research Institute, Center for Child Health, Behavior and Development, Seattle, Washington.
authors.forename: Julie
authors.initials: J
authors.lastname: McGalliard
authors.affiliation: Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio.
authors.forename: Thomas F
authors.initials: TF
authors.lastname: Boat
authors.affiliation: Kaiser Permanente Center for Effectiveness and Safety Research, Pasadena, California.
authors.forename: John L
authors.initials: JL
authors.lastname: Adams
authors.affiliation: Kaiser Permanente Center for Effectiveness and Safety Research, Pasadena, California.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: McGlynn
mesh_terms: D019985:Benchmarking; D003697:Delphi Technique; D006776:Hospitals, Pediatric; D006801:Humans; D017063:Outcome Assessment, Health Care; D019984:Quality Indicators, Health Care; D012140:Respiratory Tract Diseases / Q000175:diagnosis / Q000628:therapy*; D014481:United States