California Office of Statewide Health Planning & Development

AHRQ — Pediatric Quality Indicators (PDIs)
Area-level for California

The Agency for Healthcare Research and Quality (AHRQ) Quality Indicators (QIs) are a set of measures that provide a perspective on hospital quality of care using patient data routinely reported to OSHPD.

Pediatric Quality Indicators by County

• 2007 Pediatric Quality Indicators: pdf | xls
• 2006 Pediatric Quality Indicators: pdf | xls
• 2005 Pediatric Quality Indicators: pdf | xls

The Pediatric Quality Indicators (PDIs) can be used with hospital inpatient discharge data to provide a perspective on the quality of pediatric healthcare. Specifically, PDIs screen for problems that pediatric patients experience as a result of exposure to the healthcare system and that may be amenable to prevention by changes at the system or provider level.¹

Development of quality indicators for the pediatric population involves many of the same challenges associated with the development of quality indicators for the adult population. These challenges include the need to carefully define indicators using administrative data, establish validity and reliability, detect bias and design appropriate risk adjustment, and overcome challenges of implementation and use. However, the special population of children invokes additional, special challenges. Four factors—differential epidemiology of child healthcare relative to adult healthcare, dependency, demographics, and development—can pervade all aspects of children’s healthcare; simply applying adult indicators to younger age ranges is insufficient.¹

Area-level indicators are specified to include principal diagnosis, as well as secondary diagnoses, for the complications of care.  The specification adds cases where a patient’s risk of the complication occurred in a separate hospitalization. The PDIs calculated by OSHPD include 5 county-level Indicators:

• Asthma Admission Rate
• Diabetes Short-Term Complication Rate
• Gastroenteritis Admission Rate
• Perforated Appendix Admission Rate
• Urinary Tract Infection Admission Rate

These indicators were created using patient data submitted electronically by California-licensed hospitals. The data were not validated by OSHPD beyond the routine error-checking that occurs during the data submission process. Additional information about the methods for calculating these indicators, along with detailed technical explanations, is provided by AHRQ at their Web site. AHRQ also provides valuable guidance regarding the validity of these indicators and important limitations on their use as quality measures.

¹ Text taken from the Agency for Healthcare Research and Quality (AHRQ) Web site.