Quality Assurance of Ambulatory Child Health Care Opinions of Practicing Physicians About Proposed Criteria

This paper reports the opinions of a representative sample of 1,329 physicians providing primary care regarding criteria developed by the Joint Committee on Quality Assurance for evaluation of ambulatory child health care. Areas of care were health supervision (in four age ranges), tonsillopharyngitis, bronchial asthma, and urinary infection. The criteria had been previously appraised by 452 "experts"--academicians and practitioners. Physicians rated criteria for relevance to health outcome, and desirability for use in peer review. They also stated whether they usually performed and recorded each item and gave reasons for not recording. Agreement between the pediatricians and other physicians of the sample and the "experts" was close regarding relevance to health outcome, but many fewer criteria were recommended for peer review by the sample. A significant number of respondents said they performed but did not record many of the criteria. Documentation of only abnormal findings was the main reason given for not recording. Criteria dealing with developmental or behavioral assessment or with counseling were rated lower in all categories than more easily measured items.