Table 1.
Preventive Health Quality Measures and Approaches to Measure Calculations.
| NQF Approach | Informed-Clinician Approach | Patient-Centered Approach | ||||
|---|---|---|---|---|---|---|
|
|
|
|
||||
| Measure | Numerator Criteria | Denominator Criteria | Numerator Criteria | Denominator Criteria | Numerator Criteria | Denominator Criteria |
| Breast cancer screening | Mammogram (2 years) | Women (ages 40–69)a | (NQF criteria + completed elsewhere) | (NQF criteria - patient reasons - medical reasons) | (NQF criteria + completed elsewhere + patient reason + medical reason) | NQF criteria |
| Colorectal cancer screening | FOBT/FIT (annual); sigmoidoscopy/barium enema (5 years) colonoscopy (10 years) | Ages 50–75b | (NQF criteria + completed elsewhere) | (NQF criteria - patient reasons - medical reasons) | (NQF criteria + completed elsewhere + patient reason + medical reason) | NQF criteria |
| Cervical cancer screening | Cervical cytology/Pap test (3 years) | Women (ages 21–64)c | (NQF criteria + completed elsewhere) | (NQF criteria - patient reasons - medical reasons) | (NQF criteria + completed elsewhere + patient reason + medical reason) | NQF criteria |
| Osteoporosis screening or therapy | DEXA or medical therapy for osteoporosis | Women (ages 65–85)d | (NQF criteria + completed elsewhere) | (NQF criteria - patient reasons - medical reasons) | (NQF criteria + completed elsewhere + patient reason + medical reason) | NQF criteria |
| Pneumococcal vaccination | Pneumococcal vaccine (ever) | Ages ≥65e | (NQF criteria + completed elsewhere) | (NQF criteria - patient reasons - medical reasons) | (NQF criteria + completed elsewhere + patient reason + medical reason) | NQF criteria |
Abbreviations: DEXA, dual energy X-ray absorptiometry; FOBT/FIT, fecal occult blood testing/fecal immunochemical testing; NQF, National Quality Forum.
Denominator exclusions for breast cancer screening: bilateral mastectomy or 2 unilateral mastectomies.
Denominator exclusions for colorectal cancer screening: diagnosis of colorectal cancer or total colectomy.
Denominator exclusions for cervical cancer screening: hysterectomy with no residual cervix.
Denominator exclusions for osteoporosis screening: documentation of medical, patient, or system reason for not ordering DEXA or prescribing treatment.
Denominator exclusions for pneumococcal vaccination: does not meet age criteria.