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Clinical
Measures for Health Center Grantee Performance
Reviews –
Calendar Year 2006
| Performance
Measure: |
# 4 |
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Activity
Code(s): |
H 80 |
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| Percentage
of Children 5 through 18 years of age diagnosed
with “persistent” asthma, who
were prescribed appropriate medications. |
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| Operational Definition:
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Numerator:
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# of patients diagnosed
with mild, moderate or severe persistent
asthma, as per NHLBI guidelines, who at
last contact, have been documented to
be on anti-inflammatory medication (inhaled
corticosteroids, mast cell stabilizers,
leukotreine modifiers)
See: http://www.healthdisparities.net/hdc/html/collaboratives.topics.asthma.aspx
and:
http://www.ncqa.org/Docs/SOHCQ_2005.pdf
(page 50) |
| Denominator: |
# of patients’ 5 through18 years
of age with documented persistent asthma,
and seen at least once at the health center
for any cause during calendar year.
May use UDS Table 6, line 5, column b;
or MIS system, or similar source.
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| Unit & Text: |
numerator count / denominator count x
100 = % |
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National Numeric
Benchmark: |
Health Disparities Collaborative has
target goal of 95%, with an increase from
30% to 80% among collaborative participants.
From 2000 to 2004, HEDIS shows an improvement
from 57% to 64% among Medicaid programs
and from 63% to 73% among Commercial programs
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Data
Sources
and Data Issues:
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From registry or EHR/EMR if available.
If chart audit, then sample from the
sample frame of persons meeting denominator
criteria.
Denominator data should be readily available
from MIS and encounter or discharge code,
since reported for UDS and others. Numerator
may or may not be readily available depending
on whether participating in HEDIS reporting,
internal QA, health disparities initiative.
May require sampling and manual record
abstraction by grantee’s QA Committee.
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| Background/significance
of the measure: |
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Asthma, a
chronic inflammatory disease of the airways
is widely recognized as a concern by both
the public and health professionals and
government (HP2010 Goal 24-7). In 2003,
some 20 million people or 8 percent of
Americans were diagnosed with asthma.
In 2002, asthma accounted for some 3 million
hospital outpatient visits, 13 million
doctor visits, 500,000 hospitalizations,
and over 4,000 deaths.
Asthma is the leading cause of school
absenteeism, causing children to miss
an estimated 14 million school days annually.
Asthma accounts for an estimated 14.5
million lost workdays for adults. The
economic cost of asthma is $14 billion
annually, including $4.6 billion in lost
productivity. A 45 percent reduction in
the risk of repeat Emergency Department
visits was shown in patients using inhaled
corticosteroid treatment compared with
nonusers.
According to the UDS, this is the leading
chronic disease condition in children
cared for at health centers, and it is
the third most prevalence condition among
the people served by health centers in
2004. It is the best proxy measure for
chronic disease in children, and a good
measure for adults. Analysis of measure
involves provider education, screening,
diagnosis, follow-up, adherence to practice
guidelines, and patient education.
For clinical practice guidelines for
this measure:
For more about this measure:
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