The Method for Performance Measurement Matters: Diabetes Care Quality as Measured by Administrative Claims and Institutional Registry.

Autor: McCoy RG; Division of Primary Care Internal Medicine, Department of Medicine, Mayo Clinic, Rochester, MN.; Department of Health Sciences Research, Mayo Clinic, Rochester, MN., Tulledge-Scheitel SM; Division of Primary Care Internal Medicine, Department of Medicine, Mayo Clinic, Rochester, MN., Naessens JM; Division of Health Care Policy & Research, Department of Health Sciences Research, Mayo Clinic, Rochester, MN., Glasgow AE; Division of Health Care Policy & Research, Department of Health Sciences Research, Mayo Clinic, Rochester, MN., Stroebel RJ; Division of Primary Care Internal Medicine, Department of Medicine, Mayo Clinic, Rochester, MN., Crane SJ; Division of Primary Care Internal Medicine, Department of Medicine, Mayo Clinic, Rochester, MN., Bunkers KS; Department of Family Medicine, Mayo Clinic Health System, Owatonna, MN., Shah ND; Division of Health Care Policy & Research, Department of Health Sciences Research, Mayo Clinic, Rochester, MN.
Jazyk: angličtina
Zdroj: Health services research [Health Serv Res] 2016 Dec; Vol. 51 (6), pp. 2206-2220. Date of Electronic Publication: 2016 Feb 04.
DOI: 10.1111/1475-6773.12453
Abstrakt: Objectives: Performance measurement is used by health care providers, payers, and patients. Historically accomplished using administrative data, registries are used increasingly to track and improve care. We assess how measured diabetes care quality differs when calculated using claims versus registry.
Data Sources/study Setting: Cross-sectional analysis of administrative claims and electronic health records (EHRs) of patients in a multispecialty integrated health system in 2012 (n = 368,883).
Study Design: We calculated percent of patients attaining glycohemoglobin <8.0 percent, LDL cholesterol <100 mg/dL, blood pressure <140/90 mmHg, and nonsmoking (D4) in cohorts, identified by Medicare Accountable Care Organization/Minnesota Community Measures (ACO-MNCM; claims-based), Healthcare Effectiveness Data and Information Set (HEDIS; claims-based), and registry (EHR-based).
Data Collection/extraction Methods: Claims were linked to EHR to create a dataset of performance-eligible patients.
Principal Findings: ACO-MNCM, HEDIS, and registry identified 6,475, 6,989, and 6,425 measurement-eligible patients. Half were common among the methods; discrepancies were due to attribution, age restriction, and encounter requirements. D4 attainment was lower in ACO-MNCM (36.09 percent) and HEDIS (37.51 percent) compared to registry (43.74 percent) cohorts.
Conclusions: Registry- and claims-based performance measurement methods identify different patients, resulting in different rates of quality metric attainment with implications for innovative population health management.
(© Health Research and Educational Trust.)
Databáze: MEDLINE
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