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Quality of child health care: expanding the scope and flexibility of measurement approaches.

Quality measurement can inform and encourage improvement in child health care. Currently, most measures gauge only whether care is received (e.g., receipt of a well-child care visit), providing little information about the actual content of care. We propose a measurement framework for comprehensive well-child care to capture a richer view of children's health care and take a more efficient approach to data collection. To promote measurement development, it will be necessary to: 1) align new measures with existing reporting requirements; 2) manage the burden of data collection; 3) weigh the evidence base; 4) consider adding new types of content; 5) develop clear but flexible measure specifications; and 6) consider children's enrollment patterns in Medicaid and the Children's Health Insurance Program. It also will be important to seek opportunities for eliciting families' views on the quality of well-child care.