One key to measuring the quality of child health care may be to develop better measures of children’s ability to function.

Staffers at the National Committee for Quality Assurance, Washington, and the Commonwealth Fund, New York, make that suggestion in a new report on strategies for improving child health care quality measurement.

The NCQA, an organization that runs quality reporting programs for health maintenance organizations and preferred provider organizations, is in the process of preparing children’s health care quality measure specifications.

The new Children’s Health Insurance Program Reauthorization Act directs the secretary of Health and Human Services to identify a core set of quality measures that should be collected by all state-run CHIP plans beginning in 2010.

In the past, researchers have been able to get some basic child-health information, such as the percentage of children who have received well-child exams, but researchers have had a harder time getting specific quality information, such as information about the percentage of 2-year-olds who have had a recent well-child visit that included lead screening, vision screening, hearing screening, and comprehensive developmental screening, according to the authors of the NCQA-Commonwealth Fund report.

The authors are recommending use of a “framework for prevention” that includes measures linked to specific milestone ages, such as before an infant turns 6 months old and by a child’s sixth birthday.

One goal should be to “develop a measurement plan to increase attention to child health outcomes of broad interest, such as school readiness, workforce readiness, and family productivity,” the authors write.

“Measures of family productivity would track children’s absences from school due to illness as well as lost work days for family members who have to care for them,” the authors write. “Measures of workforce readiness would gauge adolescents’ preparedness to lead healthy and productive adult lives.”