Journal article
Measuring quality: caries-related emergency department visits and follow-up among children
Journal of public health dentistry, Vol.77(3), pp.252-262
06/2017
DOI: 10.1111/jphd.12206
PMID: 28252806
Abstract
This study validated two Dental Quality Alliance system-level measures of oral healthcare quality for children - caries-related emergency department (ED) visits and timely follow-up of those visits with a dentist - including formal validation of diagnosis codes used to identify caries-related ED visits and measurement of follow-up care.
The measures were specified for implementation with administrative claims data and validated using data from the Florida and Texas Medicaid and Children's Health Insurance Programs. Measure specification testing and measure score validation used administrative data for 7,007,765 children. We validated the diagnosis codes in claims data by comparisons with manual reviews of 300 records from a Florida hospital ED and calculation of the kappa statistic, sensitivity, and specificity.
Overall agreement in caries-related ED visit classifications between the claims data and record reviews was 87.7 percent with kappa = 0.71, sensitivity = 82 percent, and specificity = 90 percent. The calculated measure scores using administrative data found more than four-fold variation between programs with the lowest and highest caries-related ED visit rates (6.90/100,000 member months and 30.68/100,000 member months). The percentage of follow-up visits within 7 days and 30 days ranged from 22-39 percent and 34-49 percent, respectively.
These National Quality Forum endorsed measures provide valid methodologies for assessing the rate of caries-related ED visits, an important system-level outcome indicator of outpatient prevention and disease management, and the timeliness of follow-up with a dentist. There is significant variation in caries-related ED visits among state Medicaid programs, and most ED visits do not have follow-up with a dentist within 30 days.
Details
- Title: Subtitle
- Measuring quality: caries-related emergency department visits and follow-up among children
- Creators
- Jill Boylston Herndon - University of IowaJames J Crall - University of California, Los AngelesDonna L Carden - University of FloridaFrank A Catalanotto - University of FloridaScott L Tomar - University of FloridaKrishna Aravamudhan - American Dental AssociationJennifer K Light - University of FloridaElizabeth A Shenkman - University of Florida
- Resource Type
- Journal article
- Publication Details
- Journal of public health dentistry, Vol.77(3), pp.252-262
- DOI
- 10.1111/jphd.12206
- PMID
- 28252806
- NLM abbreviation
- J Public Health Dent
- ISSN
- 0022-4006
- eISSN
- 1752-7325
- Grant note
- name: Dental Quality Alliance and the American Dental Association Foundation
- Language
- English
- Date published
- 06/2017
- Academic Unit
- Public Policy Center (Archive)
- Record Identifier
- 9984283708302771
Metrics
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