Assessment of Performance Measures for Public Health, Substance Abuse, and Mental Health (1997) / Chapter Skim
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APPENDIX C: POTENTIAL HEALTH OUTCOME AND RISK STATUS MEASURES
APPENDIX C: POTENTIAL HEALTH OUTCOME AND RISK STATUS MEASURES
Pages 74-136
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From page 74... ...
The panel chose the measures listed in the first section of this appendix and detailed in the second section using the guidelines described in Chapter 1 of this report: a measure should be specific and results oriented; it should be meaningful and understandable; data should be adequate to support the measure; and the measure should be as valid, reliable, and responsive as possible. These health outcome and risk status measures are not meant to represent a mandated list.
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From page 75... ...
· Percentage of persons aged 18 and older who eat five or more servings of fruits and vegetables per days · Percentage of persons aged 14-17 (grades 9-12) who eat five or more servings of fruits and vegetables per day2 · Percentage of persons aged 18 and older who are 20 percent or more above optimal body mass index3 Exercise .
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From page 76... ...
. Percentage of women aged 50 and older who received a mammogram within past 2 years6 · Percentage of adults aged 50 and older who had a fecal occult blood test within past 12 months or a flexible sigmoidoscopy within past 5 years7 · Percentage of women aged 18 and older who received a Pap smear within past 3 years8 · Percentage of persons with diabetes who had HbAlC checked within past 12 months9 · Percentage of persons with diabetes who had a health professional examine their feet at least once within past 12 monthsl° · Percentage of persons with diabetes who received a dilated eye exam within past 12 monthsll STDs, HIV Infection, and Tuberculosis Incidence rates of selected STDs Incidence rates of HIV infection Prevalence rates of selected STDs Prevalence rates of HIV infection Consumer satisfaction with STD, HIV, and tuberculosis treatment pro grams and older Rates of sexual activity among adolescents aged 14-17 Rates of sexual activity with multiple sex partners among people aged 18 · Rates of condom use during last episode of sexual intercourse among sexually active adolescents aged 14-17 .
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From page 77... ...
. are in prisons and Jal s · Percentage of children aged 17 and younger with serious emotional disorders who are in juvenile justice facilities · Percentage of homeless persons aged 18 and older who have a serious mental illness · Percentage of adolescents aged 14-17 or family members of children and adolescents or both who are satisfied with: (a)
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From page 78... ...
· Percentage of adolescents aged 14-17 stating disapproval of marijuana use · Percentage of adolescents aged 14-17 who report parents or guardians who communicate non-use expectations · Percentage of drug abuse clients who engage in risk behaviors related to HIV/AIDS after completing treatment plan Sexual Assault Prevention · Incidence rate of sexual assault reported by females Disabilities · Percentage of newborns with neural tube defects · Percentage of persons aged 18-65 with disabilities who are in the workforce · Percentage of children aged 6 or younger with blood lead greater that 10 micrograms per deciliterls · Percentage of women who gave birth in the past year and reported using alcohol, tobacco, or other drugs during pregnancy Emergency Medical Services verve . · Percentage of persons who suffer out-of-hospital cardiac arrest who sur ~2Although the estimated incidence rate would be a more appropriate measure for monitoring progress by the state substance abuse agencies, the currently available data source for this measure provides prevalence data.
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From page 79... ...
Use of Measure: This outcome measure should be used in conjunction with relevant process and capacity measures in order to gain a sense of whether the actions taken by the state health agencies are having the desired impact. Data Resources: Behavioral Risk Factor Surveillance System (BRFSS)
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From page 80... ...
Use of Measure: This outcome measure should be used in conjunction with relevant process and capacity measures in order to gain a sense of whether the actions taken by the state health agencies are having the desired impact. Data Resources: Youth Risk Behavior Surveillance System (YRBSS)
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From page 81... ...
Limitations of Tobacco use by a state's childbearing-age female Measure: population can be affected by many factors, including exposure to advertising, availability of vending machines, and other factors that may not be under the direct control of the state health agencies. Use of Measure: This outcome measure should be used in conjunction with relevant process and capacity measures in order to gain a sense of whether the actions taken by the state health agencies are having the desired impact.
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From page 82... ...
Limitations of Policies that limit tobacco use by a state's work Measure: ing population can be affected by many factors that may not be under the direct control of the state health agencies. Use of Measure: This outcome measure should be used in conjunction with relevant process and capacity measures in order to gain a sense of whether the actions taken by the state health agencies are having the desired impact.
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From page 83... ...
Use of Measure: This outcome measure should be used in conjunction with relevant process and capacity measures in order to gain a sense of whether the actions taken by the state health agencies are having the desired impact. Data Resources: Behavioral Risk Factor Surveillance System (BRFSS)
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From page 84... ...
Limitations of Although diet has been demonstrated to have a Measure: causal link in reducing heart disease and some cancers, other factors, such as heredity, are known to affect the incidence of these diseases. Use of Measure: This outcome measure should be used in conjunction with relevant process and capacity measures in order to gain a sense of whether the actions taken by the state health agencies are having the desired impact.
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From page 85... ...
Although diet and exercise have been demonstrated to have a causal link in reducing heart disease and some cancers, other factors, such as heredity, are known to affect the incidence of these diseases. This outcome measure should be used in conjunction with relevant process and capacity measures in order to gain a sense of whether the actions taken by the state health agencies are having the desired impact.
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From page 86... ...
Use of Measure: This outcome measure should be used in conjunction with relevant process and capacity measures in order to gain a sense of whether the actions taken by the state health agencies are having the desired impact. Data Resources: Behavioral Risk Factor Surveillance System (BRFSS)
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From page 87... ...
Limitations of Although exercise has been demonstrated to Measure: have a causal link in reducing heart disease and some cancers, other factors, such as heredity, are known to affect the incidence of these diseases. Use of Measure: This outcome measure should be used in conjunction with relevant process and capacity measures in order to gain a sense of whether the actions taken by the state health agencies are having the desired impact.
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From page 88... ...
Limitations of While decreasing hypertension has been shown Measure: to be a way of improving cardiovascular and cerebrovascular functioning, other factors are known to influence the incidence of cardiovascular and cerebrovascular disease. Use of Measure: This outcome measure should be used in conjunction with relevant process and capacity measures in order to gain a sense of whether the actions taken by the state health agencies are having the desired impact.
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From page 89... ...
Limitations of While decreasing hypercholesterolemia has been Measure: shown to improve cardiovascular functioning, other factors are known to influence the incidence of cardiovascular disease. Use of Measure: This outcome measure should be used in conjunction with relevant process and capacity measures in order to gain a sense of whether the actions taken by the state health agencies are having the desired impact.
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From page 90... ...
Use of Measure: This outcome measure should be used in conjunction with relevant process and capacity measures in order to gain a sense of whether the actions taken by the state health agencies are having the desired impact. Data Resources: Behavioral Risk Factor Surveillance System (BRFSS)
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From page 91... ...
Use of Measure: This outcome measure should be used in conjunction with relevant process and capacity measures in order to gain a sense of whether the actions taken by the state health agencies are having the desired impact. Data Resources: Behavioral Risk Factor Surveillance System (BRFSS)
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From page 92... ...
Use of Measure: This outcome measure should be used in conjunction with relevant process and capacity measures in order to gain a sense of whether the actions taken by the state health agencies are having the desired impact. Data Resources: Behavioral Risk Factor Surveillance System (BRFSS)
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From page 93... ...
Limitations of While early detection of problems in controlling Measure: blood glucose levels has been shown to improve treatment outcomes for diabetes, other factors can also influence the morbidity and mortality caused by this disease. Use of Measure: This outcome measure should be used in conjunction with relevant process and capacity measures in order to gain a sense of whether the actions taken by the state health agencies are having the desired impact.
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From page 94... ...
This outcome measure should be used in conjunction with relevant process and capacity measures in order to gain a sense of whether the actions taken by the state health agencies are having the desired impact. Behavioral Risk Factor Surveillance System (BRFSS)
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From page 95... ...
Limitations of While early detection has been shown to improve Measure: treatment outcomes for diabetes, other factors can also influence the morbidity and mortality caused by this disease. Use of Measure: This outcome measure should be used in conjunction with relevant process and capacity measures in order to gain a sense of whether the actions taken by the state health agencies are having the desired impact.
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From page 96... ...
Changes in multiple incidence measures can be used to assess broader prevention efforts, e.g., those aimed at risk reduction or improving access to services. These outcome measures should be used in conjunction with relevant process and capacity measures in order to gain a sense of whether the actions taken by the state health agencies are having the desired impact.
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From page 97... ...
Use of Measure: Trends in the incidence of HIV infections are useful in measuring prevention efforts. This outcome measure should be used in conjunction with relevant process and capacity measures in order to gain a sense of whether the actions taken by the state health agencies are having the desired impact.
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From page 98... ...
When used in conjunction with relevant process and capacity measures, the measure can assist in determining whether a state effort is having the desired impact. Data Resources: Special state-based programmatic surveys; publicly supported screening programs; Regional Infertility Prevention Project; several state and local STD programs.
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From page 99... ...
Use of Measure: Consistent trends in prevalence in well-defined populations, particularly when monitored at multiple locations in a state, can provide a reasonable estimate of whether true prevalence is changing. When used in conjunction with relevant process and capacity measures, the measure can assist in determining whether a state effort is having the desired impact.
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From page 100... ...
Limitations of Variations in consumer satisfaction surveys Measure: across states make interstate comparisons problematic. Use of Measure: This outcome measure should be used in conjunction with relevant process and capacity measures in order to gain a sense of whether the actions taken by the state health agencies are having the desired impact.
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From page 101... ...
Use of Measure: This outcome measure should be used in conjunction with relevant process and capacity measures in order to gain a sense of whether the actions taken by the state health agencies are having the desired impact. Data Resources: The Youth Risk Behavior Surveillance System (YRBSS)
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From page 102... ...
Use of Measure: This outcome measure should be used in conjunction with relevant process and capacity measures in order to gain a sense of whether the actions taken by the state health agencies are having the desired impact. Data Resources: The Behavioral Risk Factor Surveillance System (BRFSS)
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From page 103... ...
Use of Measure: This outcome measure should be used in conjunction with relevant process and capacity measures in order to gain a sense of whether the actions taken by the state health agencies are having the desired impact. Data Resources: The Youth Risk Behavior Surveillance System (YRBSS)
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From page 104... ...
Use of Measure: This outcome measure should be used in conjunction with relevant process and capacity measures in order to gain a sense of whether the actions taken by the state health agencies are having the desired impact. Data Resources: The Behavioral Risk Factor Surveillance System (BRFSS)
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From page 105... ...
Use of Measure: This outcome measure should be used in conjunction with relevant process and capacity measures in order to gain a sense of whether the actions taken by the state health agencies are having the desired impact. Data Resources: The Behavioral Risk Factor Surveillance System (BRFSS)
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From page 106... ...
. Use of Measure: This outcome measure should be used in conjunction with relevant process and capacity measures in order to gain a sense of whether the actions taken by the state health agencies are having the desired impact.
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From page 107... ...
Use of Measure: The measure, when used in conjunction with measures of incidence and prevalence and the other relevant process and capacity measures, can be a useful measure of risk status in the community. Data Resou roes: State-specific treatment su rveys.
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From page 108... ...
Use of Measure: This outcome measure should be used in conjunction with relevant process and capacity measures in order to gain a sense of whether the actions taken by the state agencies are having the desired impact. Data Resources: Numerator: Consumer or provider surveys, using one or more of the following instruments: NYCMH, Basis 32, SF 36, Multnomah Community Ability Scale, and Lehman Quality of Life.
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From page 109... ...
Limitations of Variations in surveys across states make inter Measure: state comparisons problematic. Use of Measure: This outcome measure should be used in conjunction with relevant process and capacity measures in order to gain a sense of whether the actions taken by the state agencies are having the desired impact.
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From page 110... ...
Limitations of Variations in surveys across states make inter Measure: state comparisons problematic. Use of Measure: This outcome measure should be used in conjunction with relevant process and capacity measures in order to gain a sense of whether the actions taken by the state agencies are having the desired impact.
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From page 111... ...
Significant variation in quality of living situations may occur among consumers living independently or with family members. This outcome measure should be used in conjunction with relevant process and capacity measures in order to gain a sense of whether the actions taken by the state agencies are having the desired impact.
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From page 112... ...
Use of Measure: This outcome measure should be used in conjunction with relevant process and capacity measures in order to gain a sense of whether the actions taken by state agencies are having the desired impact. Data Resources Numerator: State mental health data systems; Medicaid data; child welfare data; juvenile justice data.
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From page 113... ...
The measure can be affected by many factors that may not be under the direct control of the mental health agencies. Use of Measure: This outcome measure should be used in conjunction with relevant process and capacity measures in order to gain a sense of whether the actions taken by the state agencies are having the desired impact.
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From page 114... ...
Denominator: Number of children aged 17 and younger with serious emotional disorders. Rationale for Many states identify a goal of reducing the Measure: number in juvenile justice facilities as a measure of success of mental health programs.
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From page 115... ...
Use of Measure: This outcome measure should be used in conjunction with relevant process and capacity measures in order to gain a sense of whether the actions taken by the state agencies are having the desired impact. Data Resources: Numerator: Estimates of homeless populations from local surveys and shelter information.
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From page 116... ...
Limitations of Variations in consumer satisfaction surveys Measure: across states make interstate comparisons problematic. Use of Measure: This outcome measure should be used in conjunction with relevant process and capacity measures in order to gain a sense of whether the actions taken by the state agencies are having the desired impact.
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From page 117... ...
Use of Measure: This outcome measure should be used in conjunction with relevant process and capacity measures in order to gain a sense of whether the actions taken by the state agencies are having the desired impact. Data Resources: MHSIP Report Card Survey; state surveys.
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From page 118... ...
Measure: Use of Measure: This outcome measure should be used in conjunction with relevant process and capacity measures in order to gain a sense of whether the actions taken by the state health agencies are having the desired impact. Data Resources: Numerator: State-based reportable disease registries.
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From page 119... ...
. Use of Measure: This outcome measure should be used in conjunction with relevant process and capacity measures in order to gain a sense of whether the actions taken by the state health agencies are having the desired impact.
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From page 120... ...
. Use of Measure: This outcome measure should be used in conjunction with relevant process and capacity measures in order to gain a sense of whether the actions taken by the state agencies are having the desired impact.
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From page 121... ...
Limitations of The causes reported for emergency room en Measure: counters may understate the actual number of emergency room encounters due to alcohol or other drugs. Use of Measure: This outcome measure should be used in conjunction with relevant process and capacity measures in order to gain a sense of whether the actions taken by the state agencies are having the desired impact.
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From page 122... ...
Limitations of Many personal and socioeconomic factors can Measure: influence alcohol and drug use that are difficult for a state agency to measure in the short term. Use of Measure: This outcome measure should be used in conjunction with relevant process and capacity measures in order to gain a sense of whether the actions taken by the state agencies are having the desired impact.
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From page 123... ...
Use of Measure: This outcome measure should be used in conjunction with relevant process and capacity measures in order to gain a sense of whether the actions taken by the state health agencies are having the desired impact. Data Resources: Uniform Crime Reporting; state client data systems (e.g., Colorado Drug/Alcohol Coordinated Data Systems)
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From page 124... ...
In addition, a school-based measure misses dropouts, who may be at increased risk for substance abuse. Use of Measure: This outcome measure should be used in conjunction with relevant process and capacity measures in order to gain a sense of whether the actions taken by the state agencies are having the desired impact.
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From page 125... ...
Use of Measure: This outcome measure should be used in conjunction with relevant process and capacity measures in order to gain a sense of whether the actions taken by the state agencies are having the desired impact. Data Resources: Behavioral Risk Factor Surveillance System (BRFSS)
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From page 126... ...
Data Resources: Birth records; Behavioral Risk Factor Surveillance System (BFRSS) ; adverse pregnancy outcome registry; maternal and child health case management records Limitations of Data: The methodology used to collect BRFSS may vary significantly across states, making interstate comparisons problematic, unless supported by other data sources, such as state screening and reporting systems or medical information systems.
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From page 127... ...
Youth Risk Behavior Surveillance System (YRBSS) ; state student surveys The methodology used to collect YRBSS data may vary significantly across states, making interstate comparisons with these data alone problematic.
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From page 128... ...
are often not included in surveys. Use of Measure: This outcome measure should be used in conjunction with relevant process and capacity measures in order to gain a sense of whether the actions taken by the state agencies are having the desired impact.
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From page 129... ...
are often not included in surveys. Use of Measure: This outcome measure should be used in conjunction with relevant process and capacity measures in order to gain a sense of whether the actions taken by the state agencies are having the desired impact.
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From page 130... ...
Limitations of Many personal and socioeconomic factors can Measure: influence alcohol and drug use that are difficult for a state agency to measure in the short term. Use of Measure: This outcome measure should be used in conjunction with relevant process and capacity measures in order to gain a sense of whether the actions taken by the state agencies are having the desired impact.
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From page 131... ...
(This measure corresponds to Healthy People 2000 Objective 7.12.) Limitations of Sexual assault experienced by a state's female Measure: population can be affected by many factors, including state law enforcement, availability of special educational programs for young adolescents, availability of counseling services for offenders, and other factors that may not be under the direct control of the state's health agency.
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From page 132... ...
Use of Measure: This outcome measure should be used in conjunction with relevant process and capacity measures in order to gain a sense of whether the actions taken by the state health agencies are having the desired impact. Data Resources: Numerator: Birth records or adverse pregnancy outcome registries.
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From page 133... ...
Limitations of There may be individuals with certain disabilities Measure: for whom working is not possible. Use of Measure: This outcome measure should be used in conjunction with relevant process and capacity measures in order to gain a sense of whether the actions taken by the state health agencies are having the desired impact.
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From page 134... ...
(This measure corresponds to Healthy People 2000 Objective 11.4.) Limitations of Lead intoxication in young children living in a Measure: state can be affected by many factors, such as the average age of the housing stock, that may not be under the direct control of the health agencies.
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From page 135... ...
Use of Measure: This outcome measure should be used in conjunction with relevant process and capacity measures in order to gain a sense of whether the actions taken by the state health agencies are having the desired impact. Data Resources: Birth records; Behavioral Risk Factor Surveillance System (BFRSS)
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From page 136... ...
None of these factors is within the control of a local or regional emergency medical services system. Use of Measure: This outcome measure should be used in conjunction with relevant process and capacity measures in order to gain a sense of whether the actions taken by EMS providers are having the desired impact.
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