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Clinical
Measures for Health Center Grantee Performance
Reviews –
Calendar Year 2006
| Performance
Measure: |
# 1 |
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Activity
Code(s): |
H 80 |
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| Percentage
of pregnant women, beginning prenatal care
by end of first trimester Note:
If grantee utilizes a national risk assessment
tool e.g., POPRAS, Hollister, Creasy,
etc; description is as follows:
Percentage of women beginning
prenatal care by the end of first trimester
and documented as receiving perinatal
medical risk assessment. |
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| Definition: |
Numerator:
|
Number of women beginning
prenatal care by the end of first trimester
during the reporting year as reported in
UDS (Table 7 row16, column a) |
| Denominator: |
Number of women beginning prenatal care
during the reporting year as reported in
UDS (Table 7 sum of rows 16,17,18 columns
a ) |
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| UDS Benchmark:
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UDS Grantee comparison report Clinical
information U2.53: The UDS report:
% of late entry to prenatal care. For UDS
report on % of first prenatal enrollment
a roll up request for the information on
Table 7 column 16 can be requested. The
National UDS benchmark for this measure
is 60.9% in CY2004.
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| National
Benchmark: |
HP 2010 Objective 16-16a:
‘Increase the proportion of pregnant
women who receive early and adequate perinatal
care beginning in the first trimester of
pregnancy to 90 percent.’ (Baseline:
83 percent in 1998.)
MCHB Women’s Health USA 2005:
The percentage of mothers receiving prenatal
care in their first trimester of pregnancy
increased slightly from 2002 to 2003,
from 83.7 percent to 84.1 percent. Overall
this figure has risen 11 percent since
1990, when only 75.8 percent of women
received first trimester care. |
Data Sources
and Data Issues:
|
HP2010:
http://www.healthypeople.gov/document/HTML/tracking/od16.htm#prenatalcare
UDS Table 7 part B column 16 (Trimester
of first known visit for women receiving
prenatal care at the center during the
reporting year)
HEDIS:
Data is reported as ‘timeliness
of prenatal care‘(% of women beginning
prenatal care during their first trimester
or within 42 days of enrollment if already
pregnant at the time of enrollment). 2004
Data goes from 83. 3 in 2000 to 90.8 for
2004.
MCHB
Women’s Health USA 2005:
CDC
National Center for Health Statistics:
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| Background/significance
of the measure: |
| Early
identification of maternal disease and risks
for complications of pregnancy is the primary
reason for initiation of early (i.e. during
the first trimester) prenatal care. Prenatal
care is a critical factor in achieving a
healthy pregnancy outcome. Early prenatal
care helps to reduce the incidence of perinatal
illness, disability, death and financial
burden, by allowing the health care providers
to better manage chronic conditions and
pregnancy-related risks. In addition, providing
early prenatal care and health care advice
to mothers better permits the formation
of the vital provider-patient partnership.
There is evidence-based data on the importance
of early prenatal care in reducing infant
mortality and achieving healthy maternal
and infant outcomes. HEDIS data refers to
studies showing that mothers receiving no
prenatal care have infant mortality rates
over five times that of mothers with prenatal
care initiated in the first trimester.
Since the health risk status of the women
could change at any time during her pregnancy,
it is important to note that risk assessment
is not a one time, static function. It
must be an ongoing process throughout
the prenatal visits. The POPRAS, Hollister
forms are set to be updated at each prenatal
visit. Therefore these records must show
evidence that risk assessments occurred
throughout the prenatal period.
This measure is linked to the goals and
objectives outlined for the Perinatal
Life Cycle expectations of the BPHC and
assists national efforts to ensure early
entrance into prenatal care.
See:
http://www.qualitymeasures.ahrq.gov/summary/summary.aspx?doc_id=474
http://www.ncqa.org/Docs/SOHCQ_2005.pdf
(page 49)
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