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 16–20 yEars CoMMERCIAl MEDICARE MEDICAID HMo PPo HMo PPo HMo 2010 40.8 38.1 NA NA 54.6 2009 41.0 37.7 NA NA 54.4 2008 40.1 36.7 NA NA 52.7 2007 36.4 32.4 NA NA 48.6 2006 36.2 29.4 NA NA 50.5 2005 34.4 26.2 NA NA 49.2 2004 32.6 NA NA NA 45.9 2003 30.4 NA NA NA 44.3 2002 26.7 NA NA NA 40.8 2001 24.5 NA NA NA 39.6 2000 23.6 NA NA NA NA 1999 18.5 NA NA NA NA yEAR 21–24 yEars CoMMERCIAl MEDICARE MEDICAID HMo PPo HMo PPo HMo 2010 45.7 41.9 NA NA 62.3 2009 45.4 41.4 NA NA 61.6 2008 43.5 39.4 NA NA 59.4 2007 39.2 34.9 NA NA 54.0 2006 38.0 31.2 NA NA 55.0 2005 35.2 27.6 NA NA 52.5 2004 31.7 NA NA NA 49.0 2003 29.1 NA NA NA 46.0 2002 24.5 NA NA NA 41.5 2001 22.1 NA NA NA 41.1 2000 20.7 NA NA NA NA 1999 16.0 NA NA NA NA yEAR total ratE 81 CoMMERCIAl MEDICARE MEDICAID HMo PPo HMo PPo HMo 2010 43.1 40.0 NA NA 57.5 2009 43.1 39.5 NA NA 56.7 2008 41.7 38.0 NA NA 54.9 2007 38.1 33.8 NA NA 50.7 2006 37.3 30.4 NA NA 52.4 2005 34.9 26.9 NA NA 50.7 2004 32.2 NA NA NA 47.2 2003 29.7 NA NA NA 44.9 2002 25.4 NA NA NA 40.9 2001 23.1 NA NA NA 40.4 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 82 • Mental illness accounts for more burden from disease than all forms of cancer combined. 3 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 folloW-UP AfTER HoSPITAlIzATIoN foR MENTAl IllNESS Mental illness affects about 1 in 4 adults, and approximately 15 million adults in the United States suffer from a serious mental illness. 1,2 less than half of adults with a serious mental illness receive treatment or counseling. 2 The Follow-Up After Hospitalization for Mental Illness measure assesses whether patients 6 years of age and older who were hospitalized for treatment of selected mental health disorders were seen by a mental health provider. • The World Health organization has reported that 4 of the 10 leading causes of disability in the U.S. and other developed countries are mental disorders. by 2020, it is expected that mental illness will be the leading cause of disability in the world for women and children. 4 • Half of first-time psychiatric patients were readmitted within two years of hospital discharge; appropriate follow-up care is known to reduce the risk of repeat hospitalization. 5,6 the Case for Improvement • The economic burden of serious mental illness is estimated at $317 billion dollars and includes the cost of health services, loss of earning and disability benefits. 7 • Suicide is the 11th leading cause of death in the U.S., accounting for 30,000 deaths each year, and could be caused by untreated depression. 8 • In 2008, 30 million adults received treatment for mental health problems. 9 In 2005, more than 2 million patients were discharged from a hospital with a mental disorder. 10 HEdIs Measure definition The percentage of discharges for members 6 years of age and older who were hospitalized for treatment of selected mental health disorders and who had an outpatient visit, an intensive outpatient encounter or partial hospitalization with a mental health practitioner. The measure separately identifies the percentage of members who received follow-up within 7 and 30 days of discharge. results Proper follow-up treatment for psychiatric hospitalization can lead to improved quality of life for patients, families and society as a whole.
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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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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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