MEASURING HEALTH OUTCOME IN PEDIATRICS - DEVELOPMENT OF THE RAHC MEASURE OF FUNCTION

Objective: To develop a generic measure of health outcome (the RAHC Me asure of Function) for paediatric health services. Methodology: The RA HC Measure of Function (MOF) was modified from the Child Global Assess ment Scale. The utility and reliability of the MOF was then tested by inter-clinician agreement on case scenarios, by inter-clinician agreem ent in outpatients, by parent-clinician agreement in outpatients and b y responsiveness to change in acute admissions. Results: The inter-cli nician agreement on MOF ratings for case scenarios was moderately good , with an overall kappa of 0.42; P<0.0001. Clinicians at respiratory a nd child psychiatry clinics nominated the same or adjacent MOF categor y to describe 100% (95% CI:71.5-100) and 90% (95% CI:68.3-98.8%) of 11 and 20 cases assessed, respectively. Parents nominated the same or ad jacent MOF category as the attending clinician for 89.7% (95% CI:72.7- 97.8) and 82.9% (95% CI:67.9-92.9) of 29 and 41 children in the same t wo clinics. Twenty-eight inpatient children had an MOF assessed on adm ission and discharge, and the median MOF score improved from 50.5 to 7 9 points (z = 4.53; P<0.0001). Conclusions: The MOF is easy to use and provides a valuable description of health outcome that parents are ab le to understand. The MOF is moderately reliable, is likely to be suff iciently reliable to compare groups of paediatric patients and is resp onsive to change.