Quality Assessment of Treatment of Children and Adolescents with Developmental Disorders - A Feasibility Study Using the Example of Attention Deficit Hyperactivity Disorder.

ABSTRACT

The question of a possible presence of attention deficit/hyperactivity disorder (ADHD) is raised with increasing frequency in pediatric practice. There are guidelines and expert recommendations for diagnostic approaches. But there are no instruments available to evaluate the structural, process and outcome quality. In this pilot study, a set of quality indicators on the treatment quality of ADHD was analyzed in terms of their feasibility in tertiary referral centers.A set of 39 quality indicators (QI) on ADHD developed in advance in a multistage procedure was assessed at 9 tertiary referral centers, with a focus on process verifiability and feasibility. QI values were calculated as ratios for individual centers as well as across centers, followed by an explorative analysis to assess feasibility under due consideration of possible influencing factors.QI assessment is possible but highly complex and expensive in practice. Calculated QI values showed a high degree of heterogeneity between facilities as well as between institutions, which was mainly due to a lack of standardization in the documentation of required data.Basically, it is possible to assess the quality of ADHD treatment via QIs. The approach described here in assessing QIs may be also applied to other types of developmental disorders.