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

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HEdIs Measure definition 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 This measure estimates the percentage of adults 40 years of age and older with a new diagnosis or newly active CoPD who received spirometry testing to confirm the diagnosis. results Spirometry tests can improve health outcomes through early detection; promoting smoking cessation; administration of influenza and pneumococcal vaccines; and permitting earlier initiation of pharmacological and nonpharmacological treatments. 7,8 yEAR tEstIng ratE 63 CoMMERCIAl MEDICARE MEDICAID HMo PPo HMo PPo HMo 2010 41.7 40.2 33.9 35.3 31.3 2009 38.8 36.7 28.5 28.8 28.6 2008 37.6 36.4 27.7 26.5 29.3 2007 35.7 33.7 27.2 25.4 28.4 2006 36.1 33.7 26.2 30.2 27.3 C H R o N I C D I S E A S E M A N A G E M E N T
C H R o N I C D I S E A S E M A N A G E M E N T 64 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 PHARMACoTHERAPy MANAGEMENT of CoPD ExACERbATIoN Chronic obstructive pulmonary disease (CoPD) exacerbations are characterized by acute worsening of clinical symptoms (e.g., breathlessness or sputum production). Exacerbations may range from temporary decline in functional status to fatal events. 1,2 After an exacerbation, patients’ symptoms and lung function can take several weeks to recover to baseline, and quality of life declines drastically. 2 The Pharmacotherapy Management of COPD Exacerbation measure evaluates whether patients received appropriate medical treatment after an event and assesses effective outpatient management of the disease. • CoPD exacerbations are responsible for the majority of CoPD-related costs from unscheduled physician and emergency room visits and hospitalizations. 2 • Exacerbations have contributed to an increase in CoPD-related mortality, from 21.4 to 43.3 deaths per 100,000 persons in the U.S. in the last two decades. 1 • According to the Global Initiative for Chronic obstructive lung Disease guidelines, inhaled bronchodilators are a cornerstone of treatment for CoPD exacerbation. 3,4 Short-term corticosteroid therapy may also be required. 5,6 the Case for Improvement • CoPD exacerbations are estimated to result in approximately 110,000 deaths and more than 500,000 hospitalizations annually. More than $18 billion is spent on direct costs every year. 4 Hospital admissions for CoPD exacerbations average a 10-day length of stay, at a cost of $10,000 per stay. 5,6 • Approximately one-third of patients discharged from the emergency department with acute exacerbations have recurrent symptoms within 14 days, and 17 percent relapse and require hospitalization—a good indicator that patients are not getting the care they require. 3 • benefits of appropriate medical treatment include decreased duration of hospital stays and less likelihood of treatment failure. Patients also exhibit decreased frequency of exacerbations and maintain longer disease-free intervals. 5
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130 APPENDIx 1: HEDIS EffECTIVENESS
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134 APPENDIx 2: HEDIS EffECTIVENESS
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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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