A Framework to Measure and Improve Well-Being in Primary Care

Area of Science:

• Pediatric Primary Care
• Child Health Outcomes
• Healthcare Systems Improvement

Background:

• Pediatricians lack comprehensive well-being measures for primary care redesign.
• Optimizing child health and development requires robust outcome metrics.

Purpose of the Study:

• To describe the Cincinnati Kids Thrive at 5 outcome measure.
• To introduce proximal outcome and process measures for system improvement.
• To guide pediatric primary care redesign using a composite well-being metric.

Main Methods:

• Developed a composite "thriving" measure at 66 months using electronic health record data.
• Defined thriving by immunizations, BMI, vision, hearing, and developmental milestones.
• Applied the measure to 9544 patients over 3 years.

Main Results:

• Baseline thriving rates were 13% (all patients) and 31% (complete data).
• Missing data (50%) and component interdependencies complicated results interpretation.
• Significant interest exists in measuring system performance with time-linked trajectories.

Conclusions:

• The Thrive at 5 measure provides a framework for assessing pediatric well-being.
• Data challenges highlight the need for careful measure implementation and interpretation.
• A collaborative call to action is needed for pediatricians, researchers, policymakers, and communities to advance child health.