About the MCH Measures Compendium and Measure Set Profiles
How were the 12 measure sets chosen for the measure set profiles and compendium?
The 12 measure initiatives/programs included in this portal were selected based on their use within a range of MCH programs across various settings, including state Medicaid/CHIP programs, community MCH health and social services programs,
federal maternal, child, youth, and family-serving agencies, health systems, and health plans. Individual measures used by each of the 12 MCH programs/initiatives were included in this review and in the compendium as long as they were sufficiently developed to include a specific and clear measure numerator, denominator,
and data source.
Why are some measures (for example, those included in Child Stats’ America’s Children chartbook) or frameworks (such as RWJF’s Culture of Health) not included in the compendium?
The focus of the compendium is on measures in existing measure sets and initiatives that are used to monitor health and well-being, guide needs assessments, implement and evaluate quality improvement processes, and build knowledge
to advance policy, programmatic, and clinical work. The compendium is also focused on measures of health and well-being of children, adolescents, and families. There are many useful, valid measures and indicators in use that were
outside the scope of this work; however, some may be included in the future.
Why are the Head Start measures included in the profiles but not in the compendium?
Individual measures used by each of the 12 MCH programs/initiatives were included in this review as long as they were sufficiently developed to include a specific and clear measure numerator and denominator and
data source. Since the data collected through the Head Start Program Information Report’s 59-part child-health data collection instrument did not provide such information, we were unable to include Head Start measures in
the MCH-MRN’s detailed measure characterization steps. However, in the future, it appears that it would be possible to construct measures with clear numerator and denominator specifications from the data collected.
Will there be additional measures/measure sets added in the future?
We hope to include additional relevant measures/measure sets in the future as time and resources allow.
I still think there are additional, good measures in X measure set – who should I contact to get them included?
You may contact Dr Christina Bethell at email@example.com with such inquiries. We will periodically review and add new measures to the compendium as time, resources, and appropriateness for the compendium
Are these measures up-to-date?
These measures are up to date as of February 2016. We plan on updating this information semi-annually as capacity allows.
How was the measure classification framework created?
Individual measures were first anchored to the domains of measurement included in both the MCH-MRN conceptual framework and the Child Trends® Child Wellbeing Framework.
This entailed categorizing measures into one of three domains:
(1) Individual and Population Health Outcomes (Conditions, Mortality, Overall Health and Well-being, etc.)
(2) Upstream Determinants/Risk and Protective Factors (Physical and Social Environment, Education, Health Behaviors, etc.)
(3) Health Care and Services Access (Access, Insurance, Hospitalization, etc.)
Based on similarities in measures across these three domains, all 821 measures were topically categorized at 3 levels:
Level 1: All 821 measures were sorted into at least one of six high-level topics: (1) Health Care and Service Access; (2) Condition Prevalence and Health Status; (3) Mortality; (4) Social Determinants of
Health; (5) Pregnancy, Birth, and Sexual Health and (6) Mental, Emotional, and Behavioral Health. (Note that some measures fell into more than one Level 1 category).
Level 2: Next, all measures were further categorized into 40 sub-topics, reflecting the depth of measures available within each Level 1 category.
Level 3: Last, each measure was assigned to one of 205 sub-sub topics, meant to capture more specific aspects of health and well-being.
For example, the AMCHP Life Course Indicator 9, the proportion of households experiencing food insecurity, is classified as:
Level 1: Social Determinants of Health
Level 2: Economic Factors
Level 3:Food Security
Are these measures nationally endorsed?
Some measures are endorsed by the National Quality Forum (NQF); some measures are also included in the National Quality Measures Clearinghouse (NQMC) and/or the National Committee for Quality Assurance (NCQA). Endorsement simply means
that a measure has been examined in a formal way by an organization containing measurement experts, and judged to be of high quality. However, this process can take a great deal of time and resources, and is usually not covered
by grant funding. Lack of endorsement does not necessarily reflect the quality or validity of a given measure.
What are the advantages to using these measures?
Many of the measures included in the MCH-MRN’s electronic compendium are
actively used to collect and report on data for a variety of purposes. Using these measures provides the benefit of improving the harmonization of a core set of measures across MCH agencies and programs and gives easy access to
information and resources on existing measures. Standardizing measurement systems will provide evidence and guidance to support definitions of health that extend beyond the absence of disease.
Technical Definitions in the MCH Measurement Portal
What is the difference between unit of analysis and target population?
The unit of analysis is the major entity being analyzed by a measure, which could be individuals, groups, or organizations (e.g. infants, caregivers, schools, clinics, or states). The target population is the demographic
group of focus (e.g. infants, children, mothers, or pregnant women). For example, in a measure looking at the requirements for health education in high schools, the unit of analysis is high schools, but the target population is adolescents.
What does it mean for a measure to have technical specifications?
Technical specifications include numerator and denominator statements at the very least. Technical specifications can also include detailed information on the validation, development, and origin of many a measure. Measures were only
included in the compendium if they had at least the minimum technical specifications of numerator and denominator statements. See the CAHMI’s 4-part Measure Review Strategy for
more information on what defines a measure.
What are the numerator and denominator of a measure?
The denominator of a measure can be thought of as the greater overall population, for example “children age 0-5”. The numerator of a measure can be thought of as the topic being measured among the population. For,
instance an example of a numerator would be “hospitalizations among children age 0-5”.
To illustrate this concept more specifically, when considering a measure that seeks to capture the proportion of adolescents ages 13-17 who received the HPV vaccine, the denominator would be the “total population of adolescents
aged 13-17”, and the numerator would be “adolescents aged 13-17 who received a complete series of the HPV vaccine.”
What does it mean when a measure’s data source is “administrative data?”
When a measure’s data source is identified as “administrative data”, the data is typically pulled from sources such as insurance claims, birth and death certificates, and health records (both paper and electronic).
About the MCH-MRN Project
What is the MCH-MRN project?
The goal of the MCH-MRN is to create a sustainable interdisciplinary network to ensure data-driven innovation and shared accountability to improve outcomes and systems performance on behalf of the nation's children, youth, and families.
The CAHMI has contributed to this goal by identifying gaps and priority areas in MCH measurement and creating a dynamic electronic compendium of health and well-being measures of children, adolescents, and families to
advance MCH research.
Who sponsors it?
The MCH-MRN is sponsored by the U.S. Health Resources and Services Administration (HRSA), Maternal and Child Health Bureau (MCHB) (UA6MC26253). The collaborative network has been led by the CAHMI in
collaboration with the UCLA Center for Healthier Children, Families, and Communities. Funding for the 2013-2016 cycle of this grant ended in August of 2016; the CAHMI will
be leading the 2016-2019 cycle starting in September of 2016.
How can I join the MCH-MRN?
Thank you so much for your interest! Please e-mail Dr Christina Bethell at firstname.lastname@example.org for more information.
Additional MCH Measurement Resources
What are some additional CAHMI/DRC-produced measurement resources?
Systems Improvement Portal (coming soon): Get information on valid and reliable measures to assess and monitor pediatric health care quality and on policy efforts around quality
Data in Action Resource: includes links to data briefs, publications, and presentations on this topic
Data brief on Child Health Data for Quality Improvement Partnerships
Medical Home Measurement and Improvement Resources (coming soon): subpage of the Medical Home portal focusing on
resources to help states, families, and medical practices understand, measure, and improve performance of medical homes
CAHMI’s Measuring Medical Home manual
Child Version of the CAHPS Survey, created in partnership with the CAHMI
Healthy People 2030 Portal (coming soon): See where DRC data aligns with Healthy People 2020 indicators
CSHCN Screener: This is a 5-item screening tool developed by the CAHMI to identify children with special health care needs. It operationalizes
the MCHB definition of CSHCN by focusing on the health consequences a child experiences as a result of having an on-going health condition rather than on the presence of a specific diagnosis or type of disability. The screener
is used as part of the National Survey of Children’s Health and the CAHPS Chronic Conditions Supplement.
Using the Screener
Screener Items and Scoring Instructions (and Screener Items in Spanish)
CMS Manual on identifying children and adults with special health care needs
CAHMI publication in Academic Pediatrics on Taking Stock of the CSHCN Screener.
CAHMI publication on the new Title V performance measures in MCH Journal: A new performance measurement system for maternal and child health in the United States
CAHMI presentation on the MCH-MRN: Introducing the MCH Measurement Research Network [Power Point Slides, EnRich Webinar Series].
Where else can I go to find additional resources on measurement?
Below, users can find a series of reports, publications, presentations, and factsheets which provide additional information relevant to MCH measurement:
Last J, editor. A dictionary of public health. New York: Oxford University Press; 2007.
National Public Health Performance Standards Program. Acronyms, glossary, and reference terms. Atlanta, GA: Centers for Disease Control and Prevention; 2007.
Columbia University, Glossary of Epidemiology Terms, http://www.cs.columbia.edu/digigov/LEXING/CDCEPI/gloss.html
National Quality Forum, The ABCs of Measurement, http://www.qualityforum.org/Measuring_Performance/ABCs_of_Measurement.aspx
Mangione-Smith, R., Schiff, J., & Dougherty, D. (2011). Identifying Children’s Health Care Quality Measures for Medicaid and CHIP: An Evidence-Informed, Publicly Transparent Expert Process. Academic Pediatrics, 11(3).
Robert Wood Johnson Foundation (2016). From Vision to Action: Measures to Mobilize A Culture of Health
For the Public’s Health: The Role of Measurement in Action and Accountability. https://www.nap.edu/catalog/13005/for-the-publics-health-the-role-of-measurement-in-action
National Quality Forum. (2015). Pediatric Measures. http://www.qualityforum.org/Pediatric_Measures.aspx
Agency for Healthcare Research and Quality. (2015). Pediatric Quality Measures Program; Available Measures Developed by PQMP Grantees.