Validation of New Care Coordination Quality Measures for Children with Medical Complexity

• Published in: Academic pediatrics 2018-07, Vol.18 (5), p.581-588
• Main Authors: Parast, Layla, Burkhart, Q, Gidengil, Courtney, Schneider, Eric C., Mangione-Smith, Rita, Lion, Casey, McGlynn, Elizabeth A., Carle, Adam, Britto, Maria T., Elliott, Marc N.
• Format: Article
• Language: English
• Subjects: care coordination; measure development; medical complexity; pediatric quality measures
• ISSN: 1876-2859; 1876-2867
• DOI: 10.1016/j.acap.2018.03.006

To validate new caregiver-reported quality measures assessing care coordination services for children with medical complexity (CMC). A cross-sectional analysis of the associations between 20 newly developed Family Experiences with Coordination of Care (FECC) quality measures and 3 validation measures among 1209 caregivers who responded to a telephone or mailed survey from August to November 2013 in Minnesota and Washington. Validation measures included an access composite, a provider rating item, and a care coordination outcome measure, all derived from Consumer Assessments of Healthcare Providers and Systems (CAHPS) survey items. Multivariate regression was used to examine associations between the 3 validation measures and each of the 20 FECC quality measures. Nineteen of the 20 FECC quality measures were significantly and positively associated with ≥1 of the validation measures. The components of care coordination demonstrating the strongest positive association with provider ratings included: 1) having a care coordinator who was knowledgeable and supportive and advocated for the child's needs (β = 26.4; 95% confidence interval [CI], 20.0–32.8, scaled to reflect change associated with a 0-100 change in the FECC measure score); and 2) receiving a written visit summary that was useful and easy to understand (β = 22.0; 95% CI, 17.1–27.0). Nineteen newly developed FECC quality measures demonstrated convergent validity with previously validated CAHPS measures. These new measures are valid for assessing the quality of care coordination services provided to CMC and may be useful for evaluating new models of care focused on improving these services.