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 • Discussing Cessation Strategies. A rolling average represents the percentage of adults 18 years of age and older who are current smokers or tobacco users who discussed or were provided cessation methods or strategies by a physician during the measurement year. results Care providers play an important role in supporting smokers’ efforts to quit. Smoking cessation practices are among the most advantageous methods for reducing smokingrelated deaths and health care costs. 2 yEAR advIsIng sMokErs and tobaCCo usErs to QuIt CoMMERCIAl MEDICARE MEDICAID HMo PPo HMo PPo HMo 2010 76.7 71.7 NA NA 73.6 2009 NA NA 77.9 75.2 NA 2008 76.7 71.6 76.9 76.5 69.3 2007 75.8 71.0 75.8 75.4 69.4 2006 73.8 70.1 76.1 77.3 68.2 2005 71.2 66.9 75.5 77.3 65.6 2004 69.6 NA 64.7 NA 66.7 2003 68.6 NA 62.9 NA 65.8 2002 67.7 NA 61.6 NA 63.6 2001 65.7 NA 60.9 NA 63.9 2000 66.3 NA NA NA NA yEAR dIsCussIng CEssatIon stratEgIEs CoMMERCIAl MEDICARE MEDICAID HMo PPo HMo PPo HMo 2010 45.0 39.0 NA NA 38.5 2008 49.7 43.3 NA NA 40.8 2007 48.0 44.2 NA NA 39.2 2006 43.2 42.6 NA NA 36.7 2005 38.9 35.1 NA NA 33.9 2004 36.8 NA NA NA 32.7 2003 36.0 NA NA NA 32.3 yEAR dIsCussIng CEssatIon MEdICatIons 47 CoMMERCIAl MEDICARE MEDICAID HMo PPo HMo PPo HMo 2010 52.4 47.2 NA NA 42.7 2008 54.4 50.9 NA NA 40.6 2007 50.9 49.6 NA NA 38.7 2006 43.9 43.8 NA NA 35.1 2005 39.4 36.7 NA NA 31.8 2004 37.8 NA NA NA 31.3 2003 37.6 NA NA NA 31.5 W E l l N E S S A N D P R E V E N T I o N
C H R o N I C D I S E A S E M A N A G E M E N T 48 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 PERSISTENCE of bETA-bloCkER TREATMENT AfTER A HEART ATTACk Heart attacks occur when blood clots obscure the main blood vessel that feeds the heart. loss of blood flow may permanently damage the heart tissue. 1 Each year, an estimated 785,000 Americans suffer a heart attack. of these, 470,000 have had at least one heart attack before, and 150,000 are under the age of 65. 2,3 The Persistence of Beta-Blocker Treatment After a Heart Attack measure reports the number of people who had a heart attack and received beta-blocker treatment during the six months following their discharge from the hospital. • beta-blocker therapy has been shown to reduce mortality when used after a heart attack. 4 These drugs can also reduce patients’ risk for hospital readmission in the first year. 5 • beta-blocker therapy restores blood flow, which reduces damage to the heart muscle. beta-blockers slow heart rate, lower blood pressure and prevent irregular heartbeats by blocking nervous impulses or stress responses to the heart. 6,7 the Case for Improvement • Despite beta-blockers’ effectiveness, adherence to beta-blocker therapy is poor. only 45 percent of patients consistently took their medications in the first year after discharge. 8 lack of adherence has been shown to increase patients’ risk of dying. 9 • If beta-blocker adherence could be increased to 100 percent in first-time heart attack survivors for 20 years, an estimated 62,000 heart attacks would be prevented, 72,000 deaths from coronary heart disease avoided, 447,000 life-years gained and $18 million saved. 10,11 • Although the elderly benefit from betablocker therapy, many patients are not prescribed these medications. of all adults who are good candidates for beta-blocker medication, only 43.8 percent of nursing home residents and 61.4 percent of community-dwelling residents receive betablockers. Research has shown that mortality is significantly lower for nursing home patients who receive beta-blockers. 12
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128 N AT I o N A l C o M M I T T E
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130 APPENDIx 1: HEDIS EffECTIVENESS
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134 APPENDIx 2: HEDIS EffECTIVENESS
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172 MEASURE N AT I o N A l C o M M
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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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Continuous Improvement and the Expansion of Quality ... - NCQA

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