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 The percentage of adults 40 years and older who experience an CoPD exacerbation event and who were given appropriate medication therapy to manage an exacerbation. As identified by claims, a CoPD exacerbation is an inpatient or ED visit with a primary discharge diagnosis of CoPD. results CoPD medications aimed at controlling symptoms have been shown to increase exercise capacity, improve health status and reduce exacerbations. 5,7 Decreasing the frequency of an exacerbation has shown to slow the progression of CoPD and should be a critical goal of care management. 2,5 yEAR bronCHodIlators CoMMERCIAl MEDICARE MEDICAID HMo PPo HMo PPo HMo 2010 77.8 73.5 78.2 76.1 82.1 2009 78.0 75.0 76.2 74.9 80.7 2008 76.1 68.1 74.1 71.3 78.2 yEAR 65 systEMIC CortICostEroIds CoMMERCIAl MEDICARE MEDICAID HMo PPo HMo PPo HMo 2010 69.8 66.2 66.6 69.6 65.3 2009 66.1 64.1 60.9 64.2 61.8 2008 67.0 58.2 60.0 60.8 61.7 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 66 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 ANNUAl MoNIToRING foR PATIENTS oN PERSISTENT MEDICATIoNS Adverse drug events trigger 700,000 emergency department (ED) visits a year. A quarter of those visits come from adults 65 years and older. Approximately 120,000 hospital visits a year are attributable to adverse drug events, and older adults are seven times more likely to be hospitalized after an ED visit compared to the rest of the population. 1 The Annual Monitoring for Patients on Persistent Medications measure assesses whether adults were properly monitored for selected medications usually prescribed for long-term use. • Adults over 65 consume more health care than any other age group, and prescribing medications to the elderly is the most common clinical decision doctors make. 2 • Allergic reactions and unintentional overdoses are two of the most common adverse drug reactions that cause hospitalization. Rates may improve with ongoing monitoring and quality improvement. 3 the Case for Improvement • Adverse drug events are responsible for $4 billion dollars of extra medical costs annually. 4 • Adverse drug events present a public health concern as over-the-counter drugs become more available and more drugs are prescribed in an outpatient setting. • In one study, patients brought to the ED with adverse drug events caused by outpatient medications were shown to spend between three and eight more days in the hospital in the six-month period post ED visit, compared with patients admitted to the ED for other reasons. 5 better methods to identify and monitor adverse drug events may reduce avoidable hospitalizations. 3,6 HEdIs Measure definition This measure assesses the percentage of adults 18 years of age and older who received at least 180 treatment days of ambulatory medication therapy for the following therapeutic agents during the measurement year and at least one therapeutic monitoring event for the therapeutic agent in the measurement year. • Angiotensin converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARb) • Digoxin • Diuretics • Anticonvulsants A combined rate is also reported. results When patients do not adhere to a drug regimen, they have high rates of inpatient and outpatient health resource use. 7 Continued
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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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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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