CareTrack Kids—part 2. Assessing the appropriateness of the healthcare delivered to Australian children: study protocol for a retrospective medical record review

Abstract

IntroductionAustralian and international clinical practice guidelines are available for common paediatric conditions. Yet there is evidence that there are substantial variations between the guidelines, recommendations (appropriate care) and the care delivered. This paper describes a study protocol to determine the appropriateness of the healthcare delivered to Australian children for 16 common paediatric conditions in acute and primary healthcare settings.Methods and analysisA random sample of 6000–8000 medical records representing a cross-section of the Australian paediatric population will be reviewed for appropriateness of care against a set of indicators within three Australian states (New South Wales, Queensland and South Australia) using multistage, stratified sampling. Medical records of children aged <16 years who presented with at least one of the study conditions during 2012 and 2013 will be reviewed.Ethics and disseminationHuman Research Ethics Committee approvals have been received from the Sydney Children's Hospital Network, Children's Health Queensland Hospital and Health Service and Women's and Children's Hospital Network (South Australia). An application is under review for the Royal Australian College of General Practitioners. The authors will submit the results of the study to relevant journals and offer oral presentations to researchers, clinicians and policymakers at national and international conferences.

Assessing the appropriateness of the management of otitis media in Australia: A population‐based sample survey

“…The overall CTK methods have been described elsewhere. [39][40][41] Here, we describe aspects specifically relevant to otitis media.…”

Suboptimal asthma care: Lessons from Australia and a way forward

“…CareTrack Kids assessed medical practitioners' adherence to clinical practice guideline recommendations for 17 common conditions in children aged 15 years and younger across three Australian states: Queensland, New South Wales and South Australia. A robust methodology was applied to develop indicators of the quality of clinical care recommended in clinical practice guidelines A medical record review was then undertaken to estimate doctors' adherence to these indicators . Adherence to quality‐of‐care indicators across all 17 conditions was estimated at 59%.…”

“…A robust methodology was applied to develop indicators of the quality of clinical care recommended in clinical practice guidelines 3 A medical record review was then undertaken to estimate doctors' adherence to these indicators. 4 Adherence to quality-of-care indicators across all 17 conditions was estimated at 59%. Adherence varied between diseases, ranging from 43.5% for tonsillitis to 88.8% for autism.…”

Non‐indicated acid‐suppression prescribing in a tertiary paediatric hospital: An audit and costing study

“…Internationally, endeavours such as Choosing Wisely seek to measure low‐value, unnecessary care across all ages and specialties . Paediatric low‐value health practices are currently a focus of national initiatives, including the CareTrack Kids study and Royal Australasian College of Physicians' Evolve recommendations . Such initiatives consistently advise that acid‐suppression therapy (AST) is ineffective for treating infants with non‐specific symptoms, like ‘spitting up’ or unsettled behaviour …”

“…3 Paediatric low-value health practices are currently a focus of national initiatives, including the CareTrack Kids study and Royal Australasian College of Physicians' Evolve recommendations. [4][5][6] Such initiatives consistently advise that acid-suppression therapy (AST) is ineffective for treating infants with non-specific symptoms, like 'spitting up' or unsettled behaviour. 7,8 Based on The Global Consensus Definition, gastro-oesophageal reflux disease (GORD) occurs when persistent reflux of gastric contents causes 'sufficiently troublesome' symptoms and/or complications.…”