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

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yEAR 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 PostPartuM vIsIt bEtWEEn 21 and 56 days aftEr dElIvEry CoMMERCIAl MEDICARE MEDICAID HMo PPo HMo PPo HMo 2010 80.7 65.9 NA NA 64.4 2009 83.6 54.1 NA NA 64.1 2008 82.8 45.8 NA NA 62.6 2007 82.0 41.6 NA NA 58.6 2006 79.9 46.3 NA NA 59.1 2005 81.5 62.8 NA NA 57.2 2004 80.6 NA NA NA 56.5 2003 80.3 NA NA NA 55.3 2002 77.0 NA NA NA 52.1 2001 77.0 NA NA NA 53.0 frEQuEnCy of PrEnatal CarE vIsIts—>80% of ExPECtEd vIsIts yEAR 79 CoMMERCIAl MEDICARE MEDICAID HMo PPo HMo PPo HMo 2010 NA NA NA NA 61.1 2009 NA NA NA NA 61.6 2008 NA NA NA NA 58.7 2007 NA NA NA NA 59.6 2006 NA NA NA NA 58.6 2005 NA NA NA NA 55.8 2004 NA NA NA NA 51.5 2003 NA NA NA NA 48.2 2002 NA NA NA NA 41.0 2001 NA NA NA NA 39.2 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 80 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 CHlAMyDIA SCREENING IN WoMEN Chlamydia is the most commonly reported bacterial sexually transmitted disease in the United States, occurring most often among adolescent and young adult females. 1,2 Chlamydia is often known as a “silent” disease because most infected people are asymptomatic. 1 Untreated chlamydia infections can lead to serious and irreversible complications, including pelvic inflammatory disease (PID), infertility and increased risk of becoming infected with HIV. 1,3 The Chlamydia Screening in Women measure looks at the percentage of non-pregnant, sexually active women 24 years of age and younger who are screened annually for chlamydia, as recommended by the U.S. Preventive Services Task force. 4 • Approximately 75 percent of chlamydia infections in women and 95 percent in men are asymptomatic, resulting in delayed medical care and treatment. 5 • between 10 percent and 15 percent of untreated chlamydia infections result in PID, which can lead to ectopic pregnancy and infertility. 1 As many as 15 percent of women with PID will become infertile. 5 the Case for Improvement • The estimated annual cost of chlamydia infections is approximately $647 million. The lifetime medical cost of chlamydia is about $315 per case for females. If the infection leads to PID, treatment can range between $1,060 to $3,180 per case. 6 • Chlamydia is easily detected and treated, but screening remains underutilized. Challenges affecting annual screening rates include lack of awareness, social stigma, barriers to finding and treating sex partners of infected women and difficulties in measuring the public health impact. 2 • Multiple chlamydia infections increase a woman’s risk of serious reproductive health complications. 7 HEdIs Measure definition The percentage of women 16–24 years of age who were identified as sexually active and who had at least one test for chlamydia during the measurement year. results If recommended annual chlamydia screening guidelines were followed, as many as 60,000 cases of PID, 8,000 cases of chronic pelvic pain and 7,500 cases of infertility could be prevented each year. 8
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130 APPENDIx 1: HEDIS EffECTIVENESS
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132 N AT I o N A l C o M M I T T E
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134 APPENDIx 2: HEDIS EffECTIVENESS
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142 APPENDIx 4b: ACCREDITED VS. NoN
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150 APPENDIx 6b: ACCREDITED VS. NoN
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152 APPENDIx 7A: PUblICly REPoRTING
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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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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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Continuous Improvement and the Expansion of Quality ... - NCQA

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