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
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. |
|
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 |
|
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. |
|
|
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. |
||
