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 folloW-UP CARE foR CHIlDREN PRESCRIbED ADHD MEDICATIoN Attention deficit/hyperactivity disorder (ADHD) typically begins in childhood and often persists into adulthood. 1 The disorder is characterized by inattention and impulsiveness, which can result in academic underachievement, family issues and behavioral problems. 2,3 The Follow-Up Care for Children Prescribed ADHD Medication measure assesses two rates of follow-up care for children between 6 and 12 years of age who are prescribed ADHD medication. • ADHD is one of the most common mental disorders in children. Almost 4 percent of children in the United States between the ages of 4 and 10 are medicated for ADHD. 1,4,5 • Data from the National Health Interview Survey suggest that roughly half of children between 6 and 11 who are diagnosed with ADHD may also have a learning disorder. 3 The combination of attention problems caused by ADHD and the learning disorder can make it hard for a child to succeed in school. boys are twice as likely to have ADHD than girls. 1,3 the Case for Improvement • The annual cost of illness for ADHD in the U.S. is estimated to be more than $42 billion. 6 • ADHD may culminate in significant health care-related costs, including frequent unintentional injuries, co-occurring psychiatric conditions and productivity loss. 7 • Combining behavioral therapy with medication has been shown to improve behavior and could lead to a decrease in medication dependence. 8 93 HEdIs Measure definition The following two rates of this measure assess follow-up care for children prescribed an ADHD medication: • Initiation Phase: The percentage of children between 6 and 12 years of age diagnosed with ADHD who had one follow-up visit with a practitioner with prescribing authority within 30 days of their first prescription of ADHD medication. • Continuation and Maintenance Phase: The percentage of children between 6 and 12 years of age with a prescription for ADHD medication who remained on the medication for at least 210 days and had at least two follow-up visits with a practitioner in the 9 months subsequent to the Initiation Phase. results Medications used to treat ADHD have known side effects and, like all medications, need to be closely monitored by a practitioner with prescribing authority. 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 yEAR 94 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 InItIatIon CoMMERCIAl MEDICARE MEDICAID HMo PPo HMo PPo HMo 2010 38.8 38.1 NA NA 38.1 2009 36.6 35.4 NA NA 36.6 2008 35.8 34.1 NA NA 34.4 2007 33.7 31.8 NA NA 33.5 2006 33.0 30.6 NA NA 31.8 yEAR ContInuatIon CoMMERCIAl MEDICARE MEDICAID HMo PPo HMo PPo HMo 2010 43.4 43.3 NA NA 43.9 2009 41.7 39.0 NA NA 41.7 2008 40.2 37.1 NA NA 39.5 2007 38.7 34.2 NA NA 38.9 2006 38.1 30.0 NA NA 34.0
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4 N AT I o N A l C o M M I T T E E
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24 HEDIS MEASURES of CARE about HEd
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144 N AT I o N A l C o M M I T T E
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148 APPENDIx 6A: 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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