Table 1.
Measures of Clinical Quality
| Composite measure | Individual item content |
|---|---|
| Processes of care: Prevention (αST = 0.93, αMD = 0.97) | Cervical cancer screening |
| Denominator: Women 21–64 years old | |
| Numerator: Pap smear within the prior 3 years | |
| Breast cancer screening | |
| Denominator: Women 52–69 years old | |
| Numerator: Mammogram within the prior 2 years | |
| Colorectal cancer screening | |
| Denominator: Adults 51–80 years old | |
| Numerator: (1) fecal occult blood test within 1 year; or (2) flexible sigmoidoscopy within the prior 5 years; or (3) double contrast barium enema within the prior 5 years,* or (4) colonoscopy within the prior 10 years | |
| Chlamydia screening | |
| Denominator: Sexually active women 16–25 years old | |
| Numerator: Chlamydia screening test within 1 year | |
| Processes of care: Disease management (αST = 0.88, αMD = 0.94) | Cholesterol screening for patients with cardiovascular conditions |
| Denominator: Adults 18–75 years old discharged alive for acute myocardial infarction, coronary artery bypass graft or percutaneous transluminal coronary angioplasty, or who had a diagnosis of ischemic vascular disease | |
| Numerator: Low density lipoprotein (LDL) cholesterol test within 1 year | |
| Appropriate asthma medications† | |
| Denominator: Adults 18–75 years old diagnosed with persistent asthma | |
| Numerator: Provided at least one prescription for inhaled steroid, nedocromil, cromolyn sodium, leukotriene modifier, or methylxanthine during the measurement year | |
| Diabetes care: | |
| Eye exam | |
| HbA1c testing | |
| LDL cholesterol testing | |
| Nephropathy screening | |
| Denominator: Adults 18–75 years with diabetes diagnosis | |
| Numerators: Dilated eye exam within the prior year | |
| HbA1c exam within the prior year | |
| LDL cholesterol exam within the prior year | |
| Urine microalbumin exam within prior year | |
| Outcomes of care (αST = 0.86, αMD = 0.93) | Cholesterol management for patients with cardiovascular conditions |
| Denominator: Adults 18–75 years old meeting criteria for cardiovascular disease and having an LDL cholesterol test within 1 year | |
| Numerator: LDL cholesterol result <130 mg/dL | |
| Diabetes care: | |
| LDL cholesterol control diabetes care – poor HbA1c control | |
| Denominator: Adults 18–75 years old with diabetes and laboratory test within 1 year | |
| Numerators: LDL cholesterol result <130 mg/dl HbA1c >9% | |
| Controlling high blood pressure | |
| Denominator: Adults 46–85 years old with diagnosis of hypertension | |
| Numerator: Blood pressure ≤140/90 | |
*Barium enema criteria not applied to the physician-level data
†This measure was only available for the site-level analyses
αST = Cronbach’s alpha derived from site-level data, αMD = Cronbach’s alpha derived from adult physician-level data