Article Figures & Data
Figures
- FIGURE 1
In 2008, FFS cost more than PFK (P < .001) and MC cost more than PFK (P < .001). The growth in FFS costs was faster than the growth for PFK (P < .001). The difference between the MC organizations’ cost growth and PFK growth was not significant (P < .121).
Tables
Measure Definition AHRQ measuresa Accidental puncture or laceration rate Accidental punctures or lacerations (secondary diagnosis) during procedure per 1000 discharges for patients aged ≤17 y Asthma admission rate Hospital admissions with a principal diagnosis of asthma per 100 000 population aged 2 through 17 y Central venous catheter–related bloodstream infection rate Central venous catheter–related bloodstream infections (secondary diagnosis) per 1000 medical and surgical discharges for patients aged ≤17 y Diabetes short-term complications admission rate Admissions for a principal diagnosis of diabetes with short-term complications (ketoacidosis, hyperosmolarity, or coma) per 100 000 population aged 6 through 17 y Gastroenteritis admission rate Admissions for a principal diagnosis of gastroenteritis or for a principal diagnosis of dehydration with a secondary diagnosis of gastroenteritis per 100 000 population, ages 3 mo to 17 y Iatrogenic pneumothorax rate Iatrogenic pneumothorax cases (secondary diagnosis) per 1000 discharges for patients aged ≤17 y Perioperative hemorrhage or hematoma rate Perioperative hemorrhage or hematoma cases with control of perioperative hemorrhage, drainage of hematoma, or a miscellaneous hemorrhage- or hematoma-related procedure after surgery per 1000 surgical discharges for patients aged ≤17 y Postoperative respiratory failure rate Postoperative respiratory failure (secondary diagnosis), mechanical ventilation, or reintubation cases per 1000 elective surgery discharges for patients aged ≤17 y Postoperative sepsis rate Postoperative sepsis cases (secondary diagnosis) per 1000 surgery discharges for patients aged ≤17 y. Includes metrics for discharges grouped according to risk category Pressure ulcer rate Stage III or IV pressure ulcers (secondary diagnosis) per 1000 discharges among patients aged ≤17 y Urinary tract infection admission rate Admissions with a principal diagnosis of urinary tract infection per 100 000 population aged 3 mo to 17 y Pediatric patient safety for selected indicators The weighted average of the observed-to-expected ratios for: accidental puncture or laceration rate, pressure ulcer rate, iatrogenic pneumothorax rate, perioperative hemorrhage or hematoma rate, postoperative respiratory failure rate, postoperative sepsis rate, postoperative wound dehiscence rate, central venous catheter–related bloodstream infection rate Pediatric quality acute composite Composite of gastroenteritis or urinary tract infection per 100 000 population aged 6 to 17 y Pediatric quality chronic composite Composite of admissions for asthma or diabetes with short-term complications per 100 000 population aged 6 to 17 y Pediatric quality overall composite Discharges, for patients aged 6 to 17 y, that meet the inclusion and exclusion rules for any of the following: asthma admission rate, diabetes short-term complications admission rate, gastroenteritis admission rate, urinary tract infection admission rate Targeted measures NICU days NICU days per 1000 PFK member-months Well-child visits Well-child visits per 1000 PFK member-months for 3- to 6-year-olds Asthma emergency department admissions Averages of monthly asthma emergency department admissions per 1000 member-months HbA1c levels Monthly Median HbA1c levels for all known patients with diabetes mellitus who were aged <20 y and followed up through a network laboratory where results were available ↵a AHRQ Definitions from AHRQ QI Version 4.5, Pediatric Quality Indicators (www.qualityindicators.ahrq.gov).
Variable 2008–2010a (N = 418 447) 2011–2013a (N = 437 876) Age, yb 17.5 14.8 <1 1–4 23.4 23.1 5–12 36.6 38.5 13–17 22.5 23.6 Female gender 49.1 48.9 Ruralc 33.1 32.3 Urban Rural 66.9 67.7 Median household income in zip code, $c 40 325 (36 250–48 182) 40 659 (36 418–49 731) Percentage of adults ≥25 y old in zip code with a BS degreec 10.2 (7.6–15.5) 10.4 (7.7–15.5) Percentage of subjects in zip code living below the poverty levelc 19.2 (12.9–24.6) 18.8 (12.8–24.6) Percentage of children aged <5 y in zip code living below the poverty levelc 34.7 (21.0–44.1) 34.7 (21.0–44.1) Enrollment continuity Continuous enrollment ≥24 mo, January 2008–September 2013 33.8 33.1 Continuous enrollment <24 mo, January 2008–September 2013 21.7 24.4 Discontinuous enrollment ≥24 mo, January 2008–September 2013 38.2 36.4 Discontinuous enrollment <24 mo, January 2008–September 2013 6.3 6.1 Enrollment breaks No break in enrollment while enrolled, January 2008–September 2013 55.5 57.5 1 break in enrollment while enrolled, January 2008–September 2013 28.0 26.9 >1 break in enrollment while enrolled, January 2008–September 2013 16.5 15.6 BS, bachelor of science.
↵a Percentages and medians (interquartile ranges) are shown and are based on all PFK members who were aged 0 to 17 years at any point during the entire study period and who were enrolled for at least 1 month during the particular period indicated.
↵b Age was determined as of July 1, 2009, and July 1, 2012, for the 2008–2010 and 2011–2013 time periods, respectively.
↵c Based on the child’s zip code as of July 1, 2009, and July 1, 2012, for the 2008–2010 and 2011–2013 time periods, respectively. Zip code–level characteristics came from the 2007–2011 American Community Survey of the US Census Bureau. If a child was not covered by PFK on July 1, 2009, but was covered at some point during 2008–2010, the nearest date during 2008–2010 on which they were covered by PFK was used to determine these characteristics for the 2008–2010 period. If a child was not covered by PFK on July 1, 2012, but was covered at some point during 2011–2013, the nearest date during 2011–2013 on which they were covered by PFK was used to determine these characteristics for the 2011–2013 period.
Quality Measure Events/1000 2008–2010 Events/1000 2011–2013 P Accidental puncture or laceration rate 0.46 0.38 .706 Asthma admission rate 0.44 0.43 .439 Central venous catheter–related bloodstream infection rate 0.17 0.21 .999 Diabetes short-term complications admission rate 0.13 0.15 .027 Gastroenteritis admission rate 0.16 0.11 .000 Iatrogenic pneumothorax rate 0.14 0.07 .442 Perioperative hemorrhage or hematoma rate 0.00 3.99 .048 Postoperative respiratory failure rate 7.71 5.02 .445 Postoperative sepsis rate 14.58 17.63 .695 Pressure ulcer rate 0.82 0.26 .359 Urinary tract infection admission rate 0.08 0.08 .326 Pediatric patient safety for selected indicators 1.39 1.44 .918 Pediatric quality acute composite 0.12 0.09 .018 Pediatric quality chronic composite 0.46 0.43 .288 Pediatric quality overall composite 0.58 0.53 .046 P values are results from Fisher’s exact tests.
In this issue
Cost Saving and Quality of Care in a Pediatric Accountable Care Organization
Jump to section
Related Articles
Cited By...
- Oregons approach to leveraging system-level data to guide a social determinants of health-informed approach to childrens healthcare
- Trends in Pediatric Hospitalizations and Readmissions: 2010-2016
- Evolving Federal and State Health Care Policy: Toward a More Integrated and Comprehensive Care-Delivery System for Children With Medical Complexity
- Partners for Kids Care Coordination: Lessons From the Field
- Reduced Emergency Department Utilization by Patients With Epilepsy Using QI Methodology
- A Population Intervention to Improve Outcomes in Children With Medical Complexity
- Recognition and Management of Medical Complexity
- Medicaid in Ohio: The Politics of Expansion, Reauthorization, and Reform