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 oSTEoPoRoSIS MANAGEMENT IN WoMEN WHo HAD A fRACTURE osteoporosis is a weakening of the bones that puts patients at risk for bone fracture. 1 fragility fractures, like those caused by osteoporosis, are associated with chronic pain, skeletal deformities, loss of independence and increased mortality. 6 by 2012, over 12 million Americans over the age of 50 are expected to have osteoporosis. 4 The Osteoporosis Management in Women Who Had a Fracture measure assesses whether women suffering from bone fractures received a bone density test to determine if bone fragility was the underlying cause of the fracture. • Women are more likely to develop osteoporosis than men. Women lose bone density with age, 2 and a woman over 50 has a 50 percent chance of having an osteoporosis-related fracture in her lifetime. 3 once a woman has a fracture, she is at four times greater risk for another fracture. 3 • A bone mineral density test is the most effective method for determining bone health, and can identify osteoporosis, determine risk for fractures and assess response to osteoporosis treatment. 3 The U.S. Preventive Services Task force recommends that osteoporosis screening begin at 65 for most women. Women at increased risk for osteoporotic fractures should begin screening at age 60. 4 the Case for Improvement • More than 300,000 hip fractures occur each year due to osteoporosis. of these, 42,000 people die as a result. 7 117 • osteoporosis is underdiagnosed and undertreated. only one-third of patients with fragility fractures receive appropriate testing and treatment for osteoporosis. 6 osteoporosis is asymptomatic in the early stages of the disease, so most people are not aware that they have the condition. 6 A fracture may be an indicator of the presence of osteoporosis. 3,5 • osteoporosis treatment costs $17 billion annually. 7 Direct medical costs are predicted to increase to $25.3 billion annually by 2025. 8 Each year, fragility fractures are estimated to result in 500,000 hospitalizations, 800,000 emergency department visits, 2.6 million doctors’ visits and 180,000 nursing home placements. 9 M E A S U R E S T A R G E T E D A T o l D E R A D U l T S
M E A S U R E S T A R G E T E D A T o l D E R A D U l T S 118 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 HEdIs Measure definition The percentage of women 67 years of age and older who suffered a fracture and who had either a bone mineral density test or prescription for a drug to treat or prevent osteoporosis in the six months after the fracture. results osteoporosis may lead to painful bone fractures that limit mobility and put patients at risk for other adverse health conditions. osteoporosis therapy has the potential to reduce the risk of fracture by nearly 50 percent. 10 Screening and treatment can significantly improve health outcomes by preventing fractures. yEAR trEatMEnt ratE CoMMERCIAl MEDICARE MEDICAID HMo PPo HMo PPo HMo 2010 NA NA 20.7 18.5 NA 2009 NA NA 20.7 18.1 NA 2008 NA NA 20.7 18.0 NA 2007 NA NA 20.4 17.8 NA
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168 N AT I o N A l C o M M I T T E
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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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