National Academies Press: OpenBook

Leadership by Example: Coordinating Government Roles in Improving Health Care Quality (2003)

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

« Previous: Appendix A: List of Acronyms, Abbreviations, and Web Addresses
Suggested Citation:"Appendix B: Adult Diabetes Care: Performance Measurement Set for 18- to 75-Year-Olds." Institute of Medicine. 2003. Leadership by Example: Coordinating Government Roles in Improving Health Care Quality. Washington, DC: The National Academies Press. doi: 10.17226/10537.
×

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.

Suggested Citation:"Appendix B: Adult Diabetes Care: Performance Measurement Set for 18- to 75-Year-Olds." Institute of Medicine. 2003. Leadership by Example: Coordinating Government Roles in Improving Health Care Quality. Washington, DC: The National Academies Press. doi: 10.17226/10537.
×

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

Suggested Citation:"Appendix B: Adult Diabetes Care: Performance Measurement Set for 18- to 75-Year-Olds." Institute of Medicine. 2003. Leadership by Example: Coordinating Government Roles in Improving Health Care Quality. Washington, DC: The National Academies Press. doi: 10.17226/10537.
×

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.

 

Suggested Citation:"Appendix B: Adult Diabetes Care: Performance Measurement Set for 18- to 75-Year-Olds." Institute of Medicine. 2003. Leadership by Example: Coordinating Government Roles in Improving Health Care Quality. Washington, DC: The National Academies Press. doi: 10.17226/10537.
×

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.

Suggested Citation:"Appendix B: Adult Diabetes Care: Performance Measurement Set for 18- to 75-Year-Olds." Institute of Medicine. 2003. Leadership by Example: Coordinating Government Roles in Improving Health Care Quality. Washington, DC: The National Academies Press. doi: 10.17226/10537.
×
Page 158
Suggested Citation:"Appendix B: Adult Diabetes Care: Performance Measurement Set for 18- to 75-Year-Olds." Institute of Medicine. 2003. Leadership by Example: Coordinating Government Roles in Improving Health Care Quality. Washington, DC: The National Academies Press. doi: 10.17226/10537.
×
Page 159
Suggested Citation:"Appendix B: Adult Diabetes Care: Performance Measurement Set for 18- to 75-Year-Olds." Institute of Medicine. 2003. Leadership by Example: Coordinating Government Roles in Improving Health Care Quality. Washington, DC: The National Academies Press. doi: 10.17226/10537.
×
Page 160
Suggested Citation:"Appendix B: Adult Diabetes Care: Performance Measurement Set for 18- to 75-Year-Olds." Institute of Medicine. 2003. Leadership by Example: Coordinating Government Roles in Improving Health Care Quality. Washington, DC: The National Academies Press. doi: 10.17226/10537.
×
Page 161
Next: Appendix C: Technical Overview: Health Information Systems of VHA and DOD »
Leadership by Example: Coordinating Government Roles in Improving Health Care Quality Get This Book
×
Buy Paperback | $39.95 Buy Ebook | $31.99
MyNAP members save 10% online.
Login or Register to save!
Download Free PDF

The federal government operates six major health care programs that serve nearly 100 million Americans. Collectively, these programs significantly influence how health care is provided by the private sector.

Leadership by Example explores how the federal government can leverage its unique position as regulator, purchaser, provider, and research sponsor to improve care - not only in these six programs but also throughout the nation’s health care system.

The book describes the federal programs and the populations they serve: Medicare (elderly), Medicaid (low income), SCHIP (children), VHA (veterans), TRICARE (individuals in the military and their dependents), and IHS (native Americans). It then examines the steps each program takes to assure and improve safety and quality of care.

The Institute of Medicine proposes a national quality enhancement strategy focused on performance measurement of clinical quality and patient perceptions of care. The discussion on which this book focuses includes recommendations for developing and pilot-testing performance measures, creating an information infrastructure for comparing performance and disseminating results, and more. Leadership by Example also includes a proposed research agenda to support quality enhancement.

The third in the series of books from the Quality of Health Care in America project, this well-targeted volume will be important to all readers of To Err Is Human and Crossing the Quality Chasm - as well as new readers interested in the federal government’s role in health care.

  1. ×

    Welcome to OpenBook!

    You're looking at OpenBook, NAP.edu's online reading room since 1999. Based on feedback from you, our users, we've made some improvements that make it easier than ever to read thousands of publications on our website.

    Do you want to take a quick tour of the OpenBook's features?

    No Thanks Take a Tour »
  2. ×

    Show this book's table of contents, where you can jump to any chapter by name.

    « Back Next »
  3. ×

    ...or use these buttons to go back to the previous chapter or skip to the next one.

    « Back Next »
  4. ×

    Jump up to the previous page or down to the next one. Also, you can type in a page number and press Enter to go directly to that page in the book.

    « Back Next »
  5. ×

    Switch between the Original Pages, where you can read the report as it appeared in print, and Text Pages for the web version, where you can highlight and search the text.

    « Back Next »
  6. ×

    To search the entire text of this book, type in your search term here and press Enter.

    « Back Next »
  7. ×

    Share a link to this book page on your preferred social network or via email.

    « Back Next »
  8. ×

    View our suggested citation for this chapter.

    « Back Next »
  9. ×

    Ready to take your reading offline? Click here to buy this book in print or download it as a free PDF, if available.

    « Back Next »
Stay Connected!