Table 2.
Measures evaluated at primary care physician (PCP) and PCP-group levels.
| Measures* | Casemix- Adjusted PCP ICC† (SE) | Panel Size Needed for 80% Reliability‡ | PCPs with Adequate Panel Size§ | Casemix- Adjusted PCP Group ICC║ (SE) | Panel Needed for 80% Reliability‡ | PCP Groups with Adequate Panel Size§ | |
|---|---|---|---|---|---|---|---|
| Diabetes | |||||||
| ACE or ARB if proteinuric. | 2.3 (2.2) | -- | -- | 1.3 (1.3) | -- | -- | |
| Statin if indicated | 5.1 (1.8)¶ | 75 | 16.6% | 0.8 (1.2) | -- | -- | |
| Annual LDL | 3.5 (1.2)¶ | 110 | 11.4% | 0.7 (0.7) | -- | -- | |
| Semi-annual PCP evaluation | 2.7 (1.0)¶ | 145 | 4.0% | 0.6 (0.5) | -- | -- | |
| Semi-annual hemoglobin A1c | 1.9 (0.8)¶ | 203 | 1.3% | 1.5 (0.8) | -- | -- | |
| Annual foot examination | 7.1 (1.4)¶ | 53 | 39.6% | 0.1 (0.5) | -- | -- | |
| Pneumococcal vaccine | 6.7 (1.4)¶ | 57 | 36.9% | 3.0 (1.5) | -- | -- | |
| Influenza vaccine | 2.3 (0.7)¶ | 170 | 2.7% | 0.5 (0.4) | -- | -- | |
| Monitor for nephropathy | 2.5 (1.2)¶ | 155 | 0% | 0 (0) | -- | -- | |
| Annual eye examination | 4.7 (1.0)¶ | 81 | 20.8% | 0.2 (0.4) | -- | -- | |
| Antiplatelet agent if indicated | 5.1 (1.1)¶ | 75 | 20.9% | 0.7 (0.6) | -- | -- | |
| Hemoglobin A1c ≤ 7% | 1.0 (0.6) | -- | -- | 0.2 (0.3) | -- | -- | |
| Hemoglobin A1c ≤ 9% | 0 (0) | -- | -- | 0 (0) | -- | -- | |
| Blood pressure ≤ 135/80 | 1.6 (0.5)¶ | 255 | 0% | 0.6 (0.4) | -- | -- | |
| Congestive Heart Failure | |||||||
| Ejection fraction (EF) assessed | 0 (0) | -- | -- | 2.6 (1.8) | -- | -- | |
| Annual creatinine and potassium if on ACE or ARB | 5.3 (8.9) | -- | -- | 0 (0) | -- | -- | |
| Statin if indicated | 6.5 (6.2) | -- | -- | 0 (0) | -- | -- | |
| ACE or ARB if EF< 40% | 0.1 (9.3) | -- | -- | 0 (0) | -- | -- | |
| Beta-blocker if EF< 40% | 0 (0) | -- | -- | 0 (0) | -- | -- | |
| Annual LDL | 0 (0) | -- | -- | 0 (0) | -- | -- | |
| Pneumococcal vaccine | 4.9 (4.0) | -- | -- | 0.3 (1.5) | -- | -- | |
| Influenza vaccine | 1.9 (2.3) | -- | -- | 0 (0) | -- | -- | |
| Blood pressure ≤ 140/90 | 3.1 (3.3) | -- | -- | 0 (0) | -- | -- | |
| Ischemic Vascular Disease | |||||||
| Statin if indicated | 0 (0) | -- | -- | 1.8 (2.8) | -- | -- | |
| Antiplatelet agent | 1.0 (2.0) | -- | -- | 1.5 (1.4) | -- | -- | |
| Annual LDL | 5.3 (2.3)¶ | 75 | 4.2% | 0 (0) | -- | -- | |
| Beta-blocker if indicated | 0.9 (1.2) | -- | -- | 1.2 (0.9) | -- | -- | |
| Pneumococcal vaccine | 2.1 (1.2) | -- | -- | 1.6 (1.2) | -- | -- | |
| Influenza vaccine | 1.9 (1.3) | -- | -- | 0.2 (0.6) | -- | -- | |
| Blood pressure ≤ 135/80 | 3.1 (3.3) | -- | -- | 0 (0) | -- | -- | |
| Prevention | |||||||
| Pneumococcal vaccine | 4.6 (1.1)¶ | 83 | 16.9% | 1.2 (0.9) | -- | -- | |
| Breast cancer screening | 7.8 (1.2)¶ | 48 | 60.1% | 3.8 (1.6)¶ | 102 | 100 | |
| Cervical cancer screening | 3.5 (0.6)¶ | 110 | 62.9% | 2.8 (1.3)¶ | 139 | 94.1 | |
| Influenza vaccine | 2.4 (0.5)¶ | 162 | 15.7% | 0.8 (0.4) | -- | -- | |
see Table, Supplemental Digital Content 1, for a more detailed description of the measure criteria
The “Case-mix-adjusted PCP ICC” (primary care physician intra-class correlation coefficient) is the amount of total variance in the measure score that is due to differences between PCPs after controlling for patient factors, grouping by practice site, and random measurement error.
The panel size needed to obtain 80% reliability in a PCP or PCP Group's measure score was calculated using the case-mix-adjusted ICC and the Spearman-Brown Prophecy Formula.
Percentage of PCPs or PCP Groups with an adequate panel size to achieve 80% reliability.
The “Case-mix-adjusted PCP Group ICC” is the amount of total variance in the measure score that is due to differences between PCPs grouped by practice site after controlling for patient factors and random measurement error.
Denotes statistically significant ICC.