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Project Description

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As part of the PATHS Equity for Children program of research, we will explore the development of a composite measure of “Public Health Sensitive Conditions” (PHSC), for measuring the success of upstream public health and social policies and programs. We will look at the feasibility of a composite measure derived both from our project evaluation results and from expert consultation. Our proposed PHSC project would begin to develop appropriate indicator measures for an index to quantify the “success” of upstream public health and social policies and programs on child health. The PHSC is intended to mirror the widely used ACSC measure (Ambulatory Care Sensitive Conditions) which measures the “success” of primary care preventions (1-7). This methodology study will begin the work to operationalize a PHSC indicator based upon the results of our projects. Beyond input from the entire collaborative Team of the PATHS Equity for Children program (including researchers and knowledge users), we will also incorporate input from national and international research scientists. Arising from the results of the quantitative projects that comprise our program of research, we will build on the idea of critical pathways and interventions to begin brainstorming the details of a composite measure capable of reflecting variations geographically, by SES and gender, and capable of showing change over time. In the final year of the program, our Team will produce a tentative list of PHSC conditions. Then we will engage local and national/international research and program/policy experts (both on our PATHS Equity for Children’s Advisory Group and beyond) in  Delphi approaches and focus groups to help identify child outcomes that would be preventable if public health and social policies and programs were working (for example: vaccine-preventable diseases, EDI readiness, Grade 12 graduation, etc.). This will be conducted in a cost-effective manner, given today’s technology (webinar, Skype, on-line surveys and teleconferencing). Under our program, we will only begin the PHSC discussion. This will lead to future research on quantifying and validating a PHSC composite measure derived from population-based administrative databases. 


References

(1) Bindman AB, Grumbach K., Osmond D et al. Preventable hospitalizations and access to health care. JAMA 1995 July 26; 274(4):305-11.

(2) Billings J, Zeitel L, Lukomnik J, Carey TS, Blank AE, Newman L. Impact of socio-economic status on hospital use in New York City. Health Aff (Millwood) 1993; 12(1): 172-3.

(3) Blustein J, Hanson K, Shea S. Preventable hospitalizations and socioeconomic status. Health Aff (Millwood) 1998 March; 17(2): 177-89.

(4) Brown AD, Goldacre MJ, Hicks N et al. Hospitalizations for ambulatory care-sensitive conditions: a method for comparative access and quality studies using routinely collected statistics. Can J Public Health 2001 March; 92(2): 155-9.

(5) Casanova C, Starfield B. Hospitalizations of children and access to primary care: a cross-national comparison. Int J Health Serv 1995; 25(2): 283-94.

(6) Roos LL, Walld R, Uhanova J, Bond R. Physician visits, hospitalizations, and socioeconomic status: ambulatory care sensitive conditions in a Canadian setting. Health Serv Res 2005 August; 40(4): 1167-85.

(7) Roos NP, Mustard CA. Variations in health and health care use by socioeconomic status in Winnipeg, Canada: does the system work well? Yes and no. Millbank Q 1997; 75(1): 89-111.