Continuous Improvement and the Expansion of Quality ... - NCQA

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T H E S TAT E o f H E A l T H C A R E Q U A l I T y 2 0 1 1 • H E D I S M E A S U R E S o f C A R E WEIGHT ASSESSMENT AND CoUNSElING foR NUTRITIoN AND PHySICAl ACTIVITy foR CHIlDREN/ADolESCENTS The prevalence of overweight and obesity among young people in the U.S. has increased dramatically in the past few decades; it has more than doubled in children and tripled in adolescents. 1 Childhood obesity has become a health crisis that affects children’s healthy growth and development and increases their risks for serious health problems later in life. 2 The Weight Assessment and Counseling for Nutrition and Physical Activity in Children/Adolescents measure evaluates the percentage of children and adolescents who are regularly screened for weight problems and have received counseling about healthy eating and physical activity. • An estimated 17 percent (12.5 million) of all children and adolescents in the U.S. are overweight or obese. 2,3 • overweight and obesity occurs when more calories are consumed than the body can burn during physical activity. 4 • Childhood overweight and obesity is determined by measuring body mass index (bMI). A child with a bMI at or above the 85th percentile but lower than the 95th percentile for children of the same sex and age is classified as overweight. A child with a bMI at or above the 95th percentile for children of the same age and sex is classified as obese. 5 the Case for Improvement • According to a 2009 study, the cost of hospitalizations related to childhood obesity rose from $125.9 million in 2001 to $237.6 million in 2005. America spends as much as $147 billion annually on the 103 direct and indirect costs of obesity—9.1 percent of medical spending. 6,7 • obese children are more likely to have high blood pressure and high cholesterol, risk factors for cardiovascular disease; increased risk of impaired glucose tolerance, insulin resistance and type 2 diabetes; breathing problems, including sleep apnea and asthma; joint problems and musculoskeletal discomfort; fatty liver disease; gallstones; and gastroesophageal reflux. 7 • obese children and adolescents are at greater risk of having social and psychological problems, including discrimination and poor self-esteem, which can continue into adulthood. 7 HEdIs Measure definition The percentage of children 3–17 years of age who had an outpatient visit with a primary care physician or an ob/GyN and who had evidence of bMI percentile documentation and counseling for nutrition and physical activity M E A S U R E S T A R G E T E D A T C H I l D R E N A N D A D o l E S C E N T S
M E A S U R E S T A R G E T E D A T C H I l D R E N A N D A D o l E S C E N T S during the measurement year. because bMI norms for youths vary with age and gender, this measure evaluates whether bMI percentile is assessed rather than an absolute bMI value. results If children are overweight or obese, obesity in adulthood is likely to be more severe. Adult obesity is associated with a number of serious health conditions, including heart disease, diabetes and some cancers. 8 It is important for parents and care providers to monitor a child’s weight status. Children need guidance on maintaining healthy eating and exercising habits. yEAR bMI PErCEntIlE (ovErall) CoMMERCIAl MEDICARE MEDICAID HMo PPo HMo PPo HMo 2010 35.2 10.9 NA NA 37.3 2009 35.4 17.4 NA NA 30.3 yEAR 104 N AT I o N A l C o M M I T T E E f o R Q U A l I T y A S S U R A N C E CounsElIng for nutrItIon (ovErall) CoMMERCIAl MEDICARE MEDICAID HMo PPo HMo PPo HMo 2010 37.4 11.8 NA NA 45.6 2009 41.0 20.3 NA NA 41.9 yEAR CounsElIng for PHysICal aCtIvIty (ovErall) CoMMERCIAl MEDICARE MEDICAID HMo PPo HMo PPo HMo 2010 35.3 10.5 NA NA 36.7 2009 36.5 17.6 NA NA 32.5 frEQuEnCy of PrEnatal CarE vIsIts—
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4 N AT I o N A l C o M M I T T E E
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24 HEDIS MEASURES of CARE about HEd
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S A f E T y A N D P o T E N T I A l
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W E l l N E S S A N D P R E V E N T
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C H R o N I C D I S E A S E M A N A
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C H R o N I C D I S E A S E M A N A
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Page 131 and 132: 130 APPENDIx 1: HEDIS EffECTIVENESS
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154 N AT I o N A l C o M M I T T E
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158 APPENDIx 8: PUblICly REPoRTING
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172 MEASURE N AT I o N A l C o M M
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174 APPENDIx 14b: VARIATIoN IN PlAN
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180 APPENDIx 16A: VARIATIoN IN PlAN
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182 APPENDIx 16b: VARIATIoN IN PlAN
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184 REfERENCES N AT I o N A l C o M
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ACkNoWlEDGMENTS Health Plans The 20
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