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Pediatric Respiratory Illness Measurement System (PRIMES) Scores and Outcomes

Rita Mangione-Smith1,2, Chuan Zhou3,2, Derek J Williams4

  • 1Seattle Children's Research Institute, Seattle Children's Hospital, Seattle, Washington; rita.mangione-smith@seattlechildrens.org.

Pediatrics
|July 28, 2019
PubMed

Insights

Higher scores on the Pediatric Respiratory Illness Measurement System (PRIMES) quality measures, particularly overuse indicators, are linked to shorter hospital stays for pediatric respiratory illnesses. This quality improvement may reduce length of stay but not patient-reported outcomes.

Area of Science:

  • Pediatric Healthcare Quality Measurement
  • Health Services Research
  • Clinical Quality Improvement

Background:

  • The Pediatric Respiratory Illness Measurement System (PRIMES) provides quality scores for common pediatric respiratory conditions.
  • Assessing the impact of PRIMES scores on clinical outcomes and patient experience is crucial for quality improvement initiatives.

Purpose of the Study:

  • To investigate the association between PRIMES composite quality scores and health-related quality of life, length of stay (LOS), and 30-day reuse in hospitalized children.
  • To determine if adherence to quality indicators, particularly overuse and underuse, impacts patient outcomes.

Main Methods:

  • A prospective cohort study involving 2334 children across 5 children's hospitals.
  • Pediatric Quality of Life Inventory (PedsQL) surveys were administered at admission and post-discharge.
  • PRIMES composite scores (overall, overuse, underuse) were calculated from medical records and analyzed using multivariable models.

Main Results:

  • Increased PRIMES overuse composite scores correlated with decreased LOS for bronchiolitis, asthma, and croup.
  • A 10-point increase in overuse scores led to significant LOS reductions (e.g., 8.8 hours for bronchiolitis).
  • PRIMES composite scores did not show a significant association with PedsQL improvement or 30-day reuse.

Conclusions:

  • Improved performance on certain PRIMES condition-specific composite measures, especially those related to overuse, is associated with reduced length of hospital stay.
  • Quality indicator adherence, particularly avoiding unnecessary care, appears to be a key factor in reducing LOS for pediatric respiratory illnesses.
Abstract

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