Child and Adolescent Health and Health Care Quality Measuring What Matters (2011) / Chapter Skim
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Appendix G: Administrative Data
Appendix G: Administrative Data
Pages 289-326
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From page 289... ...
. Current Established Child Measures: n/a Current Other Measurement Activities Using Various Child Measures, Including Established Measures and Indicators: n/a Data/Systems Available: Potential Opportunity to Be a Source for Child Measures: n/a Other Activities Producing Data That Could Potentially Be Used for Measurement: n/a Age: Measure-specific 289
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From page 290... ...
Children's hospitals are included in the reports, as well as acute care hospitals. Current Established Child Measures: n/a Current Other Measurement Activities Using Various Child Measures, Including Established Measures and Indicators: n/a Data/Systems Available: Potential Opportunity to Be a Source for Child Measures: n/a Other Activities Producing Data That Could Potentially Be Used for Measurement: n/a Age: Measure-specific
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From page 291... ...
Current Established Child Measures in a Data System That Supports Benchmarking: n/a Current Established Child Measures: Effectiveness of care (childhood immunization status, adolescent immunization status, chlamydia screening for women, and use of appropriate medications for people with asthma) ; accessibility/availability of care (children's access to primary care practitioners, annual dental visit)
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From page 292... ...
Current Established Child Measures in a Data System That Supports Benchmarking: n/a Current Established Child Measures: MCOs, behavioral health overlays (BHOs) , dental plans, medical groups, physician offices, and clinics.
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From page 293... ...
Current Other Measurement Activities Using Various Child Measures, Including Established Measures and Indicators: n/a Data/Systems Available: Potential Opportunity to Be a Source for Child Measures: n/a Other Activities Producing Data That Could Potentially Be Used for Measurement: n/a Age: Adults aged 18 and older and children aged 17 and younger. Patient completes the adult questionnaire, while patient's parent or guardian completes the child questionnaire.
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From page 294... ...
. Current Other Measurement Activities Using Various Child Measures, Including Established Measures and Indicators: n/a Data/Systems Available: Potential Opportunity to Be a Source for Child Measures: n/a Other Activities Producing Data That Could Potentially Be Used for Measurement: n/a Age: Measure-specific Frequency: Measure-specific: administered by mail, telephone, online, and in pediatric offices Race/Ethnicity: Ability to collect Unit Level: Hospital, Physician, Clinic, MCO, State: Measure-specific: provider, system, and state
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From page 295... ...
Current Other Measurement Activities Using Various Child Measures, Including Established Measures and Indicators: n/a Data/Systems Available: Potential Opportunity to Be a Source for Child Measures: n/a Other Activities Producing Data That Could Potentially Be Used for Measurement: n/a
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From page 296... ...
Current Established Child Measures in a Data System That Supports Benchmarking: n/a Current Established Child Measures: Current pediatric measures: attentiondeficit/hyperactivity disorder (ADHD) diagnosis, management and medication follow-up; all-cause readmission index; pharyngitis testing; upper respiratory infection (URI)
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From page 297... ...
Current Other Measurement Activities Using Various Child Measures, Including Established Measures and Indicators: n/a Data/Systems Available: Potential Opportunity to Be a Source for Child Measures: n/a Other Activities Producing Data That Could Potentially Be Used for Measurement: n/a Age: NQF has numerous quality measures but limited number of pediatricspecific measures, and the measures that address children are sometimes included in the numerator and denominator or a larger population; when they are separated, they are not separated by consistent age breaks as NQF is guided by evidence-based medicine. Frequency: Annually Race/Ethnicity: Sometimes collected but may not be reported Unit Level: Hospital, Physician, Clinic, MCO, State: Dependent on measure Geography: Dependent on measure Use: Improvement/Accountability: Improvement and accountability Goal: Safety/Well-Being/Permanency: Safety and well-being Data Source: Dependent on measure Limitations: n/a PHYSICIAN QUALITY REPORTING INITIATIVE (PQRI)
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From page 298... ...
, 3 referral to otologic, cancer stage documented, and multiple functional communication measures. Current Other Measurement Activities Using Various Child Measures, Including Established Measures and Indicators: n/a Data/Systems Available: Potential Opportunity to Be a Source for Child Measures: n/a Other Activities Producing Data That Could Potentially Be Used for Measurement: n/a Age: Measure-specific: some all populations and some children-specific Frequency: Annually -- calendar year Race/Ethnicity: Unknown Unit Level: Hospital, Physician, Clinic, MCO, State: Provider Geography: National: providers directly to CMS Use: Improvement/Accountability: Accountability Goal: Safety/Well-Being/Permanency: Well-being Data Source: Report information to CMS via a claims-based reporting mechanism (Medicare Part B claims)
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From page 299... ...
Current Established Child Measures in a Data System That Supports Benchmarking: n/a Current Established Child Measures: n/a Current Other Measurement Activities Using Various Child Measures, Including Established Measures and Indicators: 23 HEDIS measures: effectiveness of care (childhood immunization status, adolescent immunization status, chlamydia screening for women, and use of appropriate medications for people with asthma) ; accessibility/availability of care (children's access to primary care practitioners, annual dental visit)
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From page 300... ...
Current Established Child Measures in a Data System That Supports Benchmarking: n/a Current Established Child Measures: n/a Current Other Measurement Activities Using Various Child Measures, Including Established Measures and Indicators: Regulations require states with managed care organizations (MCO) or prepaid inpatient health plans (PIHP)
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From page 301... ...
Data/Systems Available: Potential Opportunity to Be a Source for Child Measures: n/a Other Activities Producing Data That Could Potentially Be Used for Measurement: n/a Age: See HEDIS/CAHPS Frequency: Annually
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From page 302... ...
Data/Systems Available: Potential Opportunity to Be a Source for Child Measures: n/a
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From page 303... ...
, which allows users to interface with a system that queries all participating vital records jurisdictions irrespective of the place and date of issuance and provides a multistate system for birth certificate information. Limitations: n/a FEDERAL INTERAGENCY FORUM KEY INDICATORS Current Established Child Measures in a Data System That Supports Benchmarking: n/a Current Established Child Measures: n/a Current Other Measurement Activities Using Various Child Measures, Including Established Measures and Indicators: Indicators addressing children: family and social environment; economic circumstances; determinants of use of health services; physical environment and safety; personal behavior and its effects; how children learn and progress in school; and physical, mental, and social aspects of children's health.
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From page 304... ...
. Data/Systems Available: Potential Opportunity to Be a Source for Child Measures: n/a Other Activities Producing Data That Could Potentially Be Used for Measurement: n/a Age: 2–17 with sub of 2–5, 6–11, 12–17 for dental Frequency: Annually Race/Ethnicity: Most indicators: data based on gender, age, race (white, black or African American, American Indian or Alaska Native, Asian, or Native Hawaiian or Other Pacific Islander)
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From page 305... ...
Other Activities Producing Data That Could Potentially Be Used for Measurement: n/a Age: n/a Frequency: Some of the data collections are conducted annually, and others are conducted periodically Race/Ethnicity: n/a Unit Level: Hospital, Physician, Clinic, MCO, State: n/a Geography: Includes only events occurring within the United States (50 states and the District of Columbia) Use: Improvement/Accountability: n/a Goal: Safety/Well-Being/Permanency: n/a Data Source: Survey-based systems include the National Health and Nutrition Examination Survey (NHANES)
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From page 306... ...
NATIONAL HOSPITAL DISCHARGE SURVEY (NHDS) Current Established Child Measures in a Data System That Supports Benchmarking: n/a Current Established Child Measures: n/a Current Other Measurement Activities Using Various Child Measures, Including Established Measures and Indicators: n/a Data/Systems Available: Potential Opportunity to Be a Source for Child Measures: Two collection systems: manual sample selection and transcription of information from hospital records to abstract forms by the hospital's staff or by staff of the U.S.
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From page 307... ...
NATIONAL AMBULATORY MEDICAL CARE SURVEY (NAMC) Current Established Child Measures in a Data System That Supports Benchmarking: n/a Current Established Child Measures: n/a Current Other Measurement Activities Using Various Child Measures, Including Established Measures and Indicators: n/a Data/Systems Available: Potential Opportunity to Be a Source for Child Measures: Survey based on a sample of visits to nonfederally employed office-based physicians, excluding anesthesiologists, pathologists, and radiologists.
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From page 308... ...
NATIONAL HOSPITAL AMBULATORY MEDICAL CARE SURVEY (NHAMC) Current Established Child Measures in a Data System That Supports Benchmarking: n/a Current Established Child Measures: n/a Current Other Measurement Activities Using Various Child Measures, Including Established Measures and Indicators: n/a Data/Systems Available: Potential Opportunity to Be a Source for Child Measures: National sample of visits to the emergency departments (EDs)
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From page 309... ...
DEFENSE MEDICAL SURVEILLANCE SYSTEM (DMSS) Current Established Child Measures in a Data System That Supports Benchmarking: n/a Current Established Child Measures: n/a Current Other Measurement Activities Using Various Child Measures, Including Established Measures and Indicators: n/a Data/Systems Available: Potential Opportunity to Be a Source for Child Measures: Department of Defense DMSS active surveillance system has access to the health care records, including vaccination history, for a substantial percentage of active-duty defense personnel, which can be used to determine a temporal relationship between vaccination and % incidence of an adverse event.
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From page 310... ...
Other Activities Producing Data That Could Potentially Be Used for Measurement: n/a Age: n/a Frequency: Ongoing
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From page 311... ...
Other Activities Producing Data That Could Potentially Be Used for Measurement: n/a Age: n/a Frequency: Reported quarterly, 45 days after the end of each quarter. States may opt to submit eligibility files on a delayed schedule in order to capture retroactive accretions.
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From page 312... ...
MEANINGFUL USE Current Established Child Measures in a Data System That Supports Benchmarking: n/a Current Established Child Measures: n/a Current Other Measurement Activities Using Various Child Measures, Including Established Measures and Indicators: n/a Data/Systems Available: Potential Opportunity to Be a Source for Child Measures: n/a Other Activities Producing Data That Could Potentially Be Used for Measurement: The CMS Notice of Proposed Regulation (NPRM) has established the proposed quality reporting that will be required for eligible
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From page 313... ...
DEPARTMENT OF HEALTH AND HUMAN SERVICES (HHS) GRANTEES Current Established Child Measures in a Data System That Supports Benchmarking: n/a Current Established Child Measures: n/a Current Other Measurement Activities Using Various Child Measures, Including Established Measures and Indicators: n/a Data/Systems Available: Potential Opportunity to Be a Source for Child Measures: n/a Other Activities Producing Data That Could Potentially Be Used for Measurement: Implement and evaluate provider performance measures and utilize health information technologies such as pediatric electronic health records and other quality improvement initiatives to help establish
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From page 314... ...
314 CHILD AND ADOLESCENT HEALTH a national quality system for children's health care through Medicaid and CHIP -- measures to be determined. Age: To be determined Frequency: To be determined Race/Ethnicity: To be determined Unit Level: Hospital, Physician, Clinic, MCO, State: To be determined Geography: Each state/group of states has different priority Use: Improvement/Accountability: To be determined Goal: Safety/Well-Being/Permanency: To be determined Data Source: To be determined Limitations: n/a MEDICAID ELIGIBILITY SYSTEMS: PROGRAM CODES Current Established Child Measures in a Data System That Supports Benchmarking: n/a Current Established Child Measures: n/a Current Other Measurement Activities Using Various Child Measures, Including Established Measures and Indicators: n/a Data/Systems Available: Potential Opportunity to Be a Source for Child Measures: n/a Other Activities Producing Data That Could Potentially Be Used for Measurement: State Medicaid eligibility systems have core data elements that are needed for quality measurement; however, there are numerous limitations to the data.
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From page 315... ...
POST-LICENSURE RAPID IMMUNIZATION SAFETY MONITORING (PRISM) Current Established Child Measures in a Data System That Supports Benchmarking: n/a Current Established Child Measures: n/a Current Other Measurement Activities Using Various Child Measures, Including Established Measures and Indicators: n/a Data/Systems Available: Potential Opportunity to Be a Source for Child Measures: n/a Other Activities Producing Data That Could Potentially Be Used for Measurement: Partnership between HHS and the insurance industry to allow access to vaccine exposure and outcome data, which establishes an active surveillance system that monitors the covered population for predefined adverse events, such as Guillain-Barré syndrome.
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From page 316... ...
Limitations: Covered population only DEPARTMENT OF VETERANS AFFAIRS (VA) Current Established Child Measures in a Data System That Supports Benchmarking: n/a Current Established Child Measures: n/a Current Other Measurement Activities Using Various Child Measures, Including Established Measures and Indicators: n/a Data/Systems Available: Potential Opportunity to Be a Source for Child Measures: n/a Other Activities Producing Data That Could Potentially Be Used for Measurement: VA and U.S.
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From page 317... ...
Current Established Child Measures in a Data System That Supports Benchmarking: n/a Current Established Child Measures: n/a Current Other Measurement Activities Using Various Child Measures, Including Established Measures and Indicators: n/a Data/Systems Available: Potential Opportunity to Be a Source for Child Measures: n/a Other Activities Producing Data That Could Potentially Be Used for Measurement: Automated, Internet-based, passive surveillance system developed at The Johns Hopkins University to complement the Vaccine Adverse Event Reporting System (VAERS)
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From page 318... ...
, which as an association often collaborate with CDC in efforts to follow-up on serious VAERS reports, maintain a repository of their findings. Age: n/a Frequency: n/a Race/Ethnicity: Unknown Unit Level: Hospital, Physician, Clinic, MCO, State: n/a Geography: Site-specific with CDC Use: Improvement/Accountability: n/a
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From page 319... ...
to collect data on the health effects of pandemic vaccine administration on maternal and fetal health through case-control studies. Age: n/a Frequency: Case study Race/Ethnicity: Unknown Unit Level: Hospital, Physician, Clinic, MCO, State: n/a Geography: Case study site-specific Use: Improvement/Accountability: n/a Goal: Safety/Well-Being/Permanency: n/a Data Source: Data on the health effects of pandemic vaccine administration on maternal and fetal health through case-control studies
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From page 320... ...
PATIENT SAFETY INDICATORS (PSI) Current Established Child Measures in a Data System That Supports Benchmarking: n/a Current Established Child Measures: n/a Current Other Measurement Activities Using Various Child Measures, Including Established Measures and Indicators: n/a Data/Systems Available: Potential Opportunity to Be a Source for Child Measures: n/a Other Activities Producing Data That Could Potentially Be Used for Measurement: 20 hospital: anesthesia complications, diagnosis-related group (DRG)
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From page 321... ...
Limitations: Does not exist today STATE-DESIGNED MULTISOURCE, INCLUDING COMMERCIAL, DATABASES Current Established Child Measures in a Data System That Supports Benchmarking: n/a
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From page 322... ...
Age: Varies by system Frequency: Unknown Race/Ethnicity: Unknown Unit Level: Hospital, Physician, Clinic, MCO, State: Unknown Geography: State level Use: Improvement/Accountability: n/a Goal: Safety/Well-Being/Permanency: n/a Data Source: Public systems Limitations: n/a ASSURING BETTER CHILD HEALTH AND DEVELOPMENT (ABCD) I, II, III Current Established Child Measures in a Data System That Supports Benchmarking: n/a Current Established Child Measures: n/a Current Other Measurement Activities Using Various Child Measures, Including Established Measures and Indicators: n/a
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From page 323... ...
Age: Birth to 5 years Frequency: Unknown Race/Ethnicity: Unknown Unit Level: Hospital, Physician, Clinic, MCO, State: Provider Geography: Within a state -- subset of states: Arkansas, Illinois, Minnesota, Oklahoma, and Oregon Use: Improvement/Accountability: Improvement and accountability Goal: Safety/Well-Being/Permanency: Well-being Data Source: Iowa: identified billing codes that would allow claims data to identify whether a screening assessment and diagnosis of developmental, social, and emotional or family risk concerns occurred that could be used as a data source if the preventive medicine codes were widely used. They include 99381–99383 for preventive medicine services for new patients for developmental, social, emotional, and family risk status as part of the comprehensive well-child exam.
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From page 324... ...
Seven measures: well-child visits in the first 15 months of life, and 3rd, 4th, 5th, and 6th years of life; use of appropriate medications for asthma; and access to primary care. Measures based on HEDIS, but use of HEDIS methodology is not required.
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From page 325... ...
Oregon has done preliminary work through the Public Health Medicaid Assessment Initiative (PHMAI) on the use of claims data, including encounter data, for public health surveillance.
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