A Framework for the Development of MaternalQuality of Care Indicators |
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| Authors: | Lisa M. Korst Carolina Reyes Calvin J. Hobel |
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| Affiliation: | (1) Saban Research Institute of Childrens Hospital Los Angeles, Los Angeles, USA;(2) Department of Pediatrics, Keck School of Medicine, University of Southern California, Southern California, USA;(3) Division of Research on Children, Youth, and Families, Keck School of Medicine, University of Southern California, Southern California, USA;(4) Division of Neonatal medicine, Keck School of Medicine, University of Southern California, Southern California, USA;(5) Department of Obstetrics & Gynecology, Keck School of Medicine, University of Southern California, Southern California, USA;(6) Burns and Allen Research Institute of Cedars-Sinai Medical Center, Cedars-Sinai, USA;(7) Department of Obstetrics & Gynecology, David Geffen School of Medicine, University of Southern California, Southern California, USA;(8) Division of Maternal Fetal Medicine, David Geffen School of Medicine, University of California, Los Angeles, USA;(9) Division of Women's Health Services Research and Policy, David Geffen School of Medicine, University of California, Los Angeles, USA;(10) Department of Pediatrics, David Geffen School of Medicine, University of California, Los Angeles, USA;(11) Department of Community Health Services, School of Public Health, University of California, Los Angeles, USA;(12) California Department of Health Services, California, USA;(13) Agency for Healthcare Research and Quality, Rockville, MD, USA;(14) LAC+USC Women's and Children's Hospital, 1240 North Mission Road, 5K40, Los Angeles, CA 90033, USA |
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| Abstract: | Background: In collaboration with the California Department of Health Maternal and Child Health Branch, the authors formed a Working Group to identify potential clinical indicators that could be used to inform decision making regarding maternal health care quality. Objective: To develop potential indicators for the assessment of maternal health care quality. Materials and Methods: A Working Group was convened to review information from the published literature and expert opinion. Selection of potential indicators was guided by the following goals: 1) To identify key areas for routine aggregate monitoring; 2) To include perspectives of relevant stakeholders in maternal health care services; 3) To include measures that are comprehensive and reflect a balance between maternal and fetal interests; and 4) To develop measures that would be valid, generalizable, mutable, and feasible. Results: Ninety potential indicators were identified. Each underwent a thorough review based on: its definition, objective, and validity; its contribution to innovation; the cost and timeliness of implementation; its feasibility, acceptability, and potential effectiveness; and its compatibility with ethics, values, and social policy. This process yielded 24 final indicators from the following categories: Health Status and Access (e.g., availability of 24 h inpatient anesthesia); Preconception and Interconception Care (e.g., Pap smear use); Antenatal Care (e.g., hospitalization for uncontrolled diabetes or pyelonephritis); Labor and Delivery Care (e.g., chorioamnionitis or obstetrical hemorrhage), and Postpartum Care (e.g., rate of postpartum visits). Conclusions: These potential indicators, representative of the women's health continuum, can serve as a foundation to structure the development of consensus and methods for maternal health care quality assessment. |
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| Keywords: | quality indicators health care maternal health services pregnancy |
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