Youthful Grown-up Social insurance Review (YAHCS) CAHMI-The Kid and Pre-adult Wellbeing Estimation Activity.


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Mail or Telephone Administration. 2. Testing calculation to recognize high schoolers (14-18 years of age) ... Youngster medicinal services usage (spot of consideration, times got care, ...
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Youthful Adult Health Care Survey (YAHCS) CAHMI-The Child and Adolescent Health Measurement Initiative

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Young Adult Health Care Survey (YAHCS) Central Purpose of the YAHCS: To evaluate the nature of preventive consideration gave to teenagers

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Young Adult Health Care Survey (YAHCS) Application of the YAHCS for States : Complement existing EPSDT managerial information and outline audit discoveries and subjective data from high schoolers and their folks/gatekeepers Inform State endeavors to enhance watch over youngsters To create & report important, significant data about the nature of preventive look after youthful grown-ups

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YAHCS 1. Youthful Adult Health Care Surveys (YAHCS) 56 things Mail or Telephone Administration 2. Examining calculation to distinguish youngsters (14-18 years of age) who have been consistently enlisted in Medicaid . Use based Enrollment-based 3. Rules for scoring & exhibiting the YAHCS quality measures got from the YAHCS study results .

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Motivation: Growing National Focus S-CHIP makes an extraordinary chance to evaluate and enhance administer to America\'s 40 million youths Teen wellbeing dangers uncovered Gaps in consideration recorded Acknowledging requirement for high schooler particular supplier preparing and access to care systems

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Motivation: Need for Quality Measures No present measures that give data about the nature of preventive consideration HEDIS or EPSDT "Well Visit" measures for youthful youngsters give data about access to preventive consideration. Youngsters medicinal services usage low Opportunistic guiding may happen

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Development Background CAHMI STAYING HEALTHY TASK FORCE Reviews and prescribes quality measures with respect to tyke and pre-adult wellbeing advancement and sickness counteractive action PHDS Measurement Advisory Group YAHCS Measurement Advisory Group

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Development Background Players YAHCS Measurement Advisory Group Academic specialists - Klein, Riley, Santelli, Elster Provider bunches - AAP, AMA Consumer bunches - Children now

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Development Background 2 in-individual national gatherings of CAHMI-Young Adult Health Care Advisory Group including purchasers, suppliers, scientists, policymakers, and so forth 15 Young Adult Health Care Advisory Group phone calls over course of work Innumerable messages & "constant" audit sessions among Task Force individuals & consultants, two in-individual meeting with particular Task Force individuals Field trials gathering more than 1531 instances of overview information

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Widespread Consensus on Components of Preventive Care Regular social insurance visits Private and secret consideration Screening , early recognizable proof and referrals for behavioral, passionate and therapeutic dangers to wellbeing Counseling on behavioral, enthusiastic and restorative dangers to wellbeing Culturally touchy correspondence and organizations with high schoolers, families and groups

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Quality Measures 7 Sub Scales/Measures Derived from the YAHCS 1) Counseling and screening to forestall dangerous practices 2) Counseling and screening to anticipate undesirable pregnancy and STDS 3) Counseling and screening identified with eating routine, weight and exercise 4) Counseling and screening identified with discouragement, mental health and connections 5) Care gave in a classified and private setting 6) Helpfulness of directing gave 7) Communication and experience of consideration (draft-juvenile CAHPS things)

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Why a Survey to Teens? Young people appeared to be dependable correspondents of what happens amid human services visits Survey things appeared to be solid in test-retest study

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Testing PHASE I : 35 psychological meetings high schoolers, formal clarity evaluation PHASE II : Field trials in 6 destinations (3 mail, 3 phone) 3 business; 3 open 4 CA, 1 NY, 1 FL 1531 reviews gathered Medical Care article (May, 2001) PHASE III: Robert Wood Johnson Survey (Online) Portion of the YAHCS included 1240 cases gathered PHASE IV: WA State Medicaid Pilot Study (mail/phone) 5 Medicaid HMOs 737 studies gathered

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Psychometric Properties of the YAHCS Findings from field trials in 6 wellbeing arranges YAHCS quality measures have solid develop legitimacy (Mean variable loading=.64) Strong Internal consistency (Mean Cronbach\'s alpha=.77) Concurrent Validity: Expected Associations between YAHCS things were Observed Psychometric investigations rehashed for the WA State pilots-comparable discoveries were watched

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Discriminant Validity of the Quality Measures YAHCS observed to be a doable, substantial, & dependable system for evaluating adherence to juvenile preventive administration rules. YAHCS quality measures separate among fluctuated parts of preventive consideration gave to teenagers.

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Feedback Loop Information Gathered by the YAHCS 1) Information about the Quality of Care 2) Descriptive data about youngsters

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Quality Measures 7 Sub Scales/Measures Derived from the YAHCS 1) Counseling and screening to forestall dangerous practices 2) Counseling and screening to avert undesirable pregnancy and STDS 3) Counseling and screening identified with eating regimen, weight and exercise 4) Counseling and screening identified with gloom, mental health and connections 5) Care gave in a classified and private setting 6) Helpfulness of advising gave 7) Communication and experience of consideration (draft-juvenile CAHPS things)

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Quality Improvement Opportunities For every quality measure, we demonstrate the individual things for which Highest quality is watched Lowest quality is watched

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Descriptive Information Useful for QI & Community Assessment Teen human services usage (spot of consideration, times got care, deferred care or care not got) Teen interest in unsafe practices : YRBSS things identified with sorrow, drinking, smoking, sexual movement, safety belt use. High schooler wellbeing status and life fulfillment : Adapted things from the CHIP-AE overview

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YAHCS Quality Reports Disseminated in Washington 6 Reports in Total County-Level Report 5 Health Plan-Level Reports incorporate the accompanying: Teen attributes Quality Measure Scores Cleaned, marked and scored information on plate

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Young Adult Health Care Survey in Snohomish County, Washington Comparison of verifiable and new measures

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YAHCS in Washington State Past quality estimation methodologies How FACCT-WA connected the YAHCS New data accumulated Demographic Teen human services use, investment in dangerous practices Quality of Care data How this quality data supplemented existing information gathering endeavors Lessons learned Next Steps

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Young Adult Health Care Survey Background-Quality Measures EPSDT Studies show adolescents to the least extent liable to get well-tyke care HEDIS Teen Well-Visits

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Young Adult Health Care Survey Background EPSDT Studies exhibit teenagers most drastically averse to get well-kid care Poverty connected with expanded danger for youngster social issues STD/Unintended Pregnancy Smoking Use Drug/Alcohol Abuse Youth Violence

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Fielding the YAHCS in Washington State

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YAHCS Survey Administration Snohomish County Sample All qualified MAA customers matured 14-18 years of age. 12 mos. Ceaseless enlistment in 1999 taking into consideration 1 month crevice. 1,821 teenagers chose 1,522 Mail 78% 299 Telephone 22% Adjusted reaction rate: 46.8% .

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Demographic Information About Teens

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Age 14-15 years - 41.6% 16-18 years - 58.4% Gender Male - 41.3% Female - 58.7% Race/Ethnicity White - 81.4% Non-White 18.6% Demographics

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Information about high schooler self-report about social insurance use and interest in unsafe practices

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Teen Health Care Characteristics Have you seen a specialist or other medicinal services supplier in most recent 12 months? 88.8% - yes 11.2% - no Where do you go for consideration? Specialist\'s office or facility - 70.8% Community Clinic/Health Center - 22.4% Hospital Clinic - 2.9%

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During recent months, have you felt pitiful, down or had nothing to anticipate? 56.4% - Yes 43.6% - No During recent months, have you felt miserable, down or had nothing to anticipate (examination) ? F - 66.0% M - 43.1% F - 34.0% M - 56.9% Teen Mental Health

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what number teenagers partake in 1 or each of the 3 of unsafe practices of smoking, drinking or sex: 0 out of 3 - 51.6% 1 out of 3 - 19.4% 2 out of 3 - 17.5% 3 out of 3 - 11.5% what number high schoolers take an interest in 1 or every one of the 3 of dangerous practices of smoking, drinking or sex: F - 47.2% M - 57.8% F - 21.9% M - 16.2% F - 17.9% M - 17.2% F - 13.0% M - 8.9% Teen Risky Behavior Profile

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The last time you had sex did you or your accomplice utilize a condom? 58.7% - Yes 41.3% - No The last time you had sex did you or your accomplice utilize a condom? F - 52.1% M - 70.7% F - 47.9% M - 29.3% Risky Behaviors - Sexual Intercourse

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What did we find out about the quality consideration gave to high schoolers however utilizing the YAHCS?

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Quality Measures - 0 - 100 Scale

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Variations in Quality Assessed quality by wellbeing arrangement : Significant contrasts in quality measure scores saw between wellbeing arranges Assessed quality by Teen Characteristics : Significant contrasts saw by adolescent, sex

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How does the quality data accumulated through the YAHCS supplement existing information gathering endeavors?

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Snohomish County diagram survey measures Mental wellbeing screen - 41.7% STD counteractive action/unintended pregnancy directing - 33.3% Health advancement - 37.5% Nutritional evaluation - 81.7% YAHCS measures (for health visits beneficiaries) Mental wellbeing guiding 19% STD/unintended pregnanc

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