Tools for Monitoring the Impact of Health Systems Changes: Experience in New Jersey

1
Tools for Monitoring the Impact of Health Systems
Changes Experience in New Jersey

• Lakota Kruse, M.D., M.P.H.
• Family Health Services
• New Jersey Department of Health Senior Services

2
Presentation Overview

• Context for using MCH indicators
• Selection process for indicators
• Experience to date
• Future Plans

3
Context For Using MCH Health Indicators

• State role in administering and monitoring MCH
  programs
• Evaluation of MCH programs and perinatal
  regionalization system
• Development of outcome measures
• Implementation of expanded Electronic Birth
  Certificate

4
New Jersey Perinatal Regionalization System

• Maternal Child Health Consortia - private
  non-profit organizations which are responsible
  for coordinating hospital and community-based MCH
  services

5
New Jersey Perinatal Regionalization System

• Regulations requiring regional
• - Perinatal and pediatric plans
• - System for quality improvement
• - Professional and consumer education
• - Coordination of perinatal transport system
• - Infant follow-up services, and
• - System to resolve conflicts within region

6
Need for Standardized MCH Health Indicators

• Needs assessment, program evaluation, monitor
  trends, resource allocation
• Healthy People 2000 2010
• MCH Block Grant and Performance Measures
• Outcome Measures - HEDIS, FHOP, MCH Model
  Indicators, Kids Count, SCHIP evaluation

7
Selection of Indicators

• Multiple uses
• Focused by shared concerns of MCH Consortia
• Initial steps in evolving process
• Limited by availability of data
• Consistency with other reporting requirements

8
Use of FHOP Indicators

• Conceptual framework
• Standard definitions
• Comparisons to other sources of indicators
• Starting with manageable number of infant and
  womens indicators

9
Experience with Indicators to Date

• Reported on 1996 1997 data from Electronic
  Birth Certificate
• No negative feedback
• Standardization of reports

10
Measurement Issues

• Selection of comparison groups
• Challenges of small-area analysis
• Data quality
• Extraction of information

11
Future Plans

• Expand number of indicators
• Ambulatory Care Sensitive Diagnosis
• Children with Special Health Care Needs
• Data Quality
• MCH DataMart