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Providing High-Quality Services to Children with Special Health Care Needs (CSHCN) Under Managed Care
Challenges in Health Services Research
Children's Health Care Needs
Lisa Simpson, M.B., B.Ch., M.P.H., Deputy Administrator, Agency for Health
Care Policy and Research, U.S. Department of Health and Human Services,
Lisa Simpson, Deputy Administrator for the Agency for Health Care Policy and Research (AHCPR),
provided a framework for the workshop by describing the important role of health services
research in improving quality of care for children and examining the impact of a changing health
care system on children's health. She explained that in order to determine what kinds of research
have been useful, it is necessary to examine the unique attributes of child health, such as the fact
that children are constantly developing, are dependent on adults for their care, and use different
systems of care than adults.
Dr. Simpson discussed several AHCPR research projects for children's health in the areas of
performance measure development, clinical effectiveness, and the organization and financing of
care. The specific research tools the AHCPR is developing in the area of child health include:
- A child health module in the Consumer Assessment of Health Plans Survey (CAHPS®).
- CONQUEST [Computerized Needs-Oriented Quality Measurement Evaluation System], a database of performance measures, which includes children's survey measures.
- The Medical Expenditure Panel Survey (MEPS), which is a major longitudinal effort to examine the medical expenditures of different households.
- The Secretary's Initiative on Children's Health, which intends to expand community-based programs and insurance coverage for children.
Dr. Simpson also discussed her sense that the future direction of health services
research will include more public/private partnerships, more impact research and more studies on
managed care experiences.
Perrin JM, Kuhlthau, K, Walker, DK, et al. Monitoring Health Care for Children with Chronic Conditions in a Managed Care Environment. Maternal and Child Health Journal Mar 1997;1(1):15-23.
Homer CJ, Kleinman LC, Goldmann, DA. Improving the
Quality of Health Care for Children in Health Systems. Health Services Research, forthcoming.
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