B
Adult Diabetes Care: Performance Measurement Set for 18- to 75-Year-Olds

Aspect of Care

Quality Improvement Measures (per year)

External Accountability Measures (per year)

Hemoglobin (Hb) A1c Management

All Patients:

% of patients receiving one or more HbA1c tests.

Distribution of number of tests done (0, 1, 2, 3 or more).

Distribution of most recent HbA1c value by range:

6.0 - 6.9%

7.0 - 7.9%

8.0 - 8.9%

9.0 - 9.9%

10.0% or greater

undocumented

% of patients with one or more HbA1c tests.

% of patients with most recent HbA1c level greater than 9.5%.

 

Per Patient: Number of HbA1c tests;a trend of HbA1c values.

 

Lipid Management

All Patients:

% of patients receiving at least one lipid profile (or all component tests).

Distribution of number of profiles done (0, 1, 2, 3 or more).

Distribution of most recent test values by range:

% of patients with at least one LDL-Cholesterol test.

% of patients with most recent LDL less than 130 mg/dl.



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OCR for page 158
Leadership by Example: Coordinating Government Roles in Improving Health Care Quality B Adult Diabetes Care: Performance Measurement Set for 18- to 75-Year-Olds Aspect of Care Quality Improvement Measures (per year) External Accountability Measures (per year) Hemoglobin (Hb) A1c Management All Patients: % of patients receiving one or more HbA1c tests. Distribution of number of tests done (0, 1, 2, 3 or more). Distribution of most recent HbA1c value by range: 6.0 - 6.9% 7.0 - 7.9% 8.0 - 8.9% 9.0 - 9.9% 10.0% or greater undocumented % of patients with one or more HbA1c tests. % of patients with most recent HbA1c level greater than 9.5%.   Per Patient: Number of HbA1c tests;a trend of HbA1c values.   Lipid Management All Patients: % of patients receiving at least one lipid profile (or all component tests). Distribution of number of profiles done (0, 1, 2, 3 or more). Distribution of most recent test values by range: % of patients with at least one LDL-Cholesterol test. % of patients with most recent LDL less than 130 mg/dl.

OCR for page 158
Leadership by Example: Coordinating Government Roles in Improving Health Care Quality Aspect of Care Quality Improvement Measures (per year) External Accountability Measures (per year)   Total Cholesterol HDL Cholesterol 240 mg/dl or greater less than 35 mg/dl 200 - 239 mg/dl 35 - 45 mg/dl less than 200 mg/dl greater than 45 mg/dl undocumented undocumented LDL Cholesterol Triglycerides 160 mg/dl or greater 400 mg/dl or greater 130 - 159 mg/dl 200 - 399 mg/dl 100 - 129 mg/dl less than 200 mg/dl less than 100 mg/dl undocumented undocumented     Per Patient: Number of lipid profiles;a trend of values for each test.   Urine Protein Testing All Patients: % of patients who received any test for micro-albuminuria. % of patients with no urinalysis or with negative or trace urine protein, who received a test for microalbumin. % of patients with at least one test for microalbumin during the measurement year, or if two of the three criteria for low risk are met, during the prior year; or who had evidence of medical attention for existing nephropathy.   Per Patient: Any test for microalbuminuria; if no urinalysis or with negative or trace urine protein, a test for microalbumin.   Eye Exam All Patients: % of patients receiving a dilated retinal eye exam. % of patients receiving other eye exam (e.g., funduscopic photo with interpretation or other) by type of exam. % of enrolled members who received a dilated eye exam or evaluation of retinal photographs by an optometrist or ophthalmologist during the reporting year, or during the prior year, if patient is at low

OCR for page 158
Leadership by Example: Coordinating Government Roles in Improving Health Care Quality Aspect of Care Quality Improvement Measures (per year) External Accountability Measures (per year)   Per Patient: Dilated retinal eye exam; other eye exam (e.g., funduscopic photo with interpretation or other) by type of exam. risk of retinopathy. Foot Exam All Patients: % of eligible patients receiving at least one complete foot exam (visual inspection, sensory exam with monofilament, and pulse exam). % of eligible patients receiving at least one foot exam, defined in any manner.   Per Patient: At least one complete foot exam (visual inspection, sensory exam with monofilament, and pulse exam).   Blood Pressure Management All Patients: % of patients who received a blood pressure reading at each visit. Distribution of most recent blood pressure values by range: % of patients with most recent blood pressure less than 140/90 mm Hg.   Systolic (mm Hg): Diastolic (mm Hg): less than 130 less than 80 130 - 139 80 - 89 140 - 149 90 - 99 150 - 159 100 - 109 160 - 169 110 or greater 170 - 179 undocumented 180 or greater undocumented     Per Patient: % of visits that included a blood pressure reading; most recent systolic and diastolic blood pressure reading.  

OCR for page 158
Leadership by Example: Coordinating Government Roles in Improving Health Care Quality Aspect of Care Quality Improvement Measures (per year) External Accountability Measures (per year) Influenza Immunization All Patients: % of patients who received an influenza immunization during the recommended calendar period. % of eligible patients who received an immunization or refused immunization during the calendar period. None.   Per Patient: Immunization status.   Office Visits All Patients: % of patients with two or more visits. None.   Per Patient: Two or more visits.a   aThis measure is not intended to imply an optimal number of tests or visits. Treatment must be based on individual patient needs and professional judgment. SOURCE: National Diabetes Quality Improvement Alliance, 2002.