Childhood Immunization Status (NQF 0038)

Transcription

1 Childhd Immunizatin Status (NQF 0038) EMeasure Name Childhd Immunizatin EMeasure Id Pending Status Versin Number 1 Set Id Pending Available Date N infrmatin Measurement Perid January 1, 20xx thrugh December 31, 20xx Measure Steward Natinal Cmmittee fr Quality Assurance Endrsed by Natinal Quality Frum Descriptin The percentage f children 2 years f age wh had fur diphtheria, tetanus and acellular pertussis (DTaP); three pli (IPV); ne measles, mumps and rubella (MMR); tw H influenza type B (HiB); three hepatitis B (Hep B), ne chicken px (VZV); fur pneumcccal cnjugate (PCV); tw hepatitis A (Hep A); tw r three rtavirus (RV); and tw influenza (flu) vaccines by their secnd birthday. The measure calculates a rate fr each vaccine and tw separate cmbinatin rates. Measure scring Prprtin Measure type Prcess Ratinale This measure mnitrs the apprpriate and timely use f vaccines fr children prir t their secnd birthday. Pediatric vaccines are respnsible fr preventing 10.5 millin diseases per birth chrt in the U.S. and are a cst effective preventive measure. Fr every dllar spent n immunizatins, as many as $29 can be saved in direct and indirect csts. With the develpment and use f vaccines, the prevalence f sme infectius diseases has dramatically reduced; since the beginning f the 20th century, there has been a 99% decline in vaccinepreventable disease mrbidity. Despite the established guidelines and well knwn benefits f vaccinatin, hwever, in 2007, 22.5% f children mnths f age had nt received the recmmended immunizatins. General clinical cnsensus ntes that if immunizatin practices ceased, mst infectius diseases currently prevented by vaccinatins wuld reemerge as serius health threats. This measure facilitates effrts tward infectius disease preventin amng a vulnerable subgrup f the ppulatin. Clinical Recmmendatin Statement Current CDC/ACIP Guidelines recmmend infants and tddlers receive the Hepatitis B series, fur DTaP vaccinatins, fur HiB vaccinatins, three IPV vaccinatins, ne MMR vaccinatin, fur pneumcccal cnjugate vaccinatins, and ne varicella vaccinatin. Sme cmbinatin prducts n the market include bth the DTaP and HiB vaccines and shuld nly be administered three times. In these cases, children receive three HiB vaccinatins instead f the fur mentined abve. The recmmendatin is t receive these vaccinatins between birth and 18 mnths f age. The current HEDIS specificatins allw a grace perid by measuring cmpliance with these recmmendatins between birth and age tw.

2 Reference Definitins CDC. General Recmmendatins n Immunizatin: Recmmendatins f the Advisry Cmmittee n Immunizatin Practices (ACIP). MMWR 2006; 55(RR15); Table f Cntents Ppulatin criteria Data criteria (QDS Data Elements) Summary calculatin Ppulatin criteria Initial Patient Ppulatin = AND: Patient characteristic: birth date (age) >=1 year and <2 years t capture all patients wh will reach 2 years during the measurement perid ; Denminatr = AND: All patients in the initial patient ppulatin; AND: Encunter: encunter utpatient w/pcp & bgyn ; Numeratr 1= AND: >= 4 cunt(s) f Medicatin administered: DTaP vaccine, different dates, ccurring >=42 OR: Medicatin allergy: DTaP vaccine ; OR: Diagnsis active: encephalpathy ; OR: Diagnsis active: prgressive neurlgical disrder ; Numeratr 2 = Numeratr 3 = AND: >=3 cunt(s) f Medicatin administered: IPV, different dates, ccurring >=42 OR: Medicatin allergy: IPV ; OR: Medicatin allergy: nemycin ; OR:: Medicatin allergy: streptmycin ; OR: Medicatin allergy: plymyxin ;

3 AND: Medicatin administered: MMR >=1, ccurring <2 years after the Patient OR: AND: >1 cunt(s) f Medicatin administered: mumps vaccine, ccurring <2 years after Patient Medicatin allergy: mumps vaccine ; AND: > 1 cunt(s) f Medicatin administered: measles vaccine, ccurring <2 years after Patient Medicatin allergy: measles vaccine ; AND: >1 cunt(s) f Medicatin administered: rubella vaccine, ccurring <2 years after Patient Medicatin allergy: rubella vaccine ; OR: Diagnsis reslved: measles ; AND: >1 cunt(s) f Medicatin administered: mumps vaccine, ccurring <2 years after Patient Medicatin allergy: mumps vaccine ; AND: >1 cunt(s) f Medicatin administered: rubella vaccine, ccurring <2 years after Patient Medicatin allergy: rubella vaccine ; OR: Diagnsis reslved: mumps ; AND: >1 cunt(s) f Medicatin administered: measles vaccine, ccurring <2 years after Patient Medicatin allergy: measles vaccine ; AND: >1 cunt(s) f Medicatin administered: rubella vaccine, ccurring <2 years after Patient Medicatin allergy: rubella vaccine ; OR: Diagnsis reslved: rubella ; AND: >1 cunt(s) f Medicatin administered: mumps vaccine, ccurring <2 years after Patient Medicatin allergy: mumps vaccine ; AND: >1 cunt(s) f Medicatin administered: measles vaccine, ccurring <2 years after Patient Medicatin allergy: measles vaccine ; OR: Diagnsis active: cancer f lymphreticular r histicytic tissue ; OR: Diagnsis inactive: cancer f lymphreticular r histicytic tissue ; OR: Diagnsis active: asymptmatic HIV ; OR: Diagnsis active: multiple myelma ; OR: Diagnsis active: leukemia ; OR: Medicatin allergy: MMR ; OR: Diagnsis active: immundeficiency ;

4 Numeratr 4 = Numeratr 5 = Numeratr 6 = AND: >=2 cunt(s) f Medicatin administered: HiB, ccurring >=42 days and <2 years after Patient Medicatin allergy: HiB ; AND: OR: >=3 cunt(s) f Medicatin administered: hepatitis B vaccine, ccurring < 2 years after Patient OR: Diagnsis reslved: hepatitis B diagnsis ; OR: Substance allergy: Baker s yeast ; OR: Medicatin allergy: hepatitis B vaccine ; AND: >=1 cunt(s) f Medicatin administered: VZV, ccurring < 2 years after Patient OR: Diagnsis reslved: VZV ; AND NOT OR: Diagnsis active: cancer f lymphreticular r histicytic tissue ; OR: Diagnsis inactive: cancer f lymphreticular r histicytic tissue ; OR: Diagnsis active: asymptmatic HIV ; OR: Diagnsis active: multiple myelma ; OR: Diagnsis active: leukemia ; OR: Medicatin allergy: VZV ; OR: Diagnsis active: immundeficiency ; Numeratr 7 = Numeratr 8 = AND: >=4 cunt(s) f Medicatin administered: pneumcccal vaccine, ccurring >=42 Medicatin allergy: pneumcccal vaccinatin ; AND: >=2 cunt(s) f Medicatin administered: hepatitis A vaccine, ccurring <2 years after Patient OR: Diagnsis reslved: hepatitis A diagnsis ; AND NOT: Medicatin allergy: hepatitis A vaccine ; Numeratr 9 = AND: >=2 cunt(s) f Medicatin administered: rtavirus vaccine, ccurring >=42 days and <2 years after Patient Medicatin allergy: rtavirus vaccine ;

5 Numeratr 10 = Numeratr 11 = AND: >=2 cunt(s) f Medicatin administered: influenza vaccine, ccurring >=180 OR: Diagnsis active: cancer f lymphreticular r histicytic tissue ; OR: Diagnsis inactive: cancer f lymphreticular r histicytic tissue ; OR: Diagnsis active: asymptmatic HIV ; OR: Diagnsis active: multiple myelma ; OR: Diagnsis active: leukemia ; OR: Medicatin allergy: influenza vaccine ; OR: Diagnsis active: immundeficiency ; AND: >= 4 cunt(s) f Medicatin administered: DTaP vaccine, different dates, ccurring >=42 OR: Medicatin allergy: DTaP vaccine ; OR: Diagnsis active: encephalpathy ; OR: Diagnsis active: prgressive neurlgical disrder ; AND: >=3 cunt(s) f Medicatin administered: IPV, different dates, ccurring >=42 OR: Medicatin allergy: IPV ; OR: Medicatin allergy: nemycin ; OR:: Medicatin allergy: streptmycin ; AND: Medicatin administered: MMR >=1, ccurring <2 years after the Patient OR: AND: >1 cunt(s) f Medicatin administered: mumps vaccine, ccurring <2 years after Patient Medicatin allergy: mumps vaccine ; AND: > 1 cunt(s) f Medicatin administered: measles vaccine, ccurring <2 years after Patient Medicatin allergy: measles vaccine ; AND: >1 cunt(s) f Medicatin administered: rubella vaccine, ccurring <2 years after Patient Medicatin allergy: rubella vaccine ; OR: Diagnsis reslved: measles ; AND: >1 cunt(s) f Medicatin administered: mumps vaccine, ccurring <2 years after Patient Medicatin allergy: mumps vaccine ;

6 AND: >1 cunt(s) f Medicatin administered: rubella vaccine, ccurring <2 years after Patient Medicatin allergy: rubella vaccine ; OR: Diagnsis reslved: mumps ; AND: >1 cunt(s) f Medicatin administered: measles vaccine, ccurring <2 years after Patient Medicatin allergy: measles vaccine ; AND: >1 cunt(s) f Medicatin administered: rubella vaccine, ccurring <2 years after Patient Medicatin allergy: rubella vaccine ; OR: Diagnsis reslved: rubella ; AND: >1 cunt(s) f Medicatin administered: mumps vaccine, ccurring <2 years after Patient Medicatin allergy: mumps vaccine ; AND: >1 cunt(s) f Medicatin administered: measles vaccine, ccurring <2 years after Patient Medicatin allergy: measles vaccine ; OR: Diagnsis active: cancer f lymphreticular r histicytic tissue ; OR: Diagnsis inactive: cancer f lymphreticular r histicytic tissue ; OR: Diagnsis active: asymptmatic HIV ; OR: Diagnsis active: multiple myelma ; OR: Diagnsis active: leukemia ; OR: Medicatin allergy: MMR ; OR: Diagnsis active: immundeficiency ; OR: Medicatin allergy: plymyxin ; AND: >=1 cunt(s) f Medicatin administered: VZV, ccurring < 2 years after Patient OR: Diagnsis reslved: VZV ; AND NOT OR: Diagnsis active: cancer f lymphreticular r histicytic tissue ; OR: Diagnsis inactive: cancer f lymphreticular r histicytic tissue ; OR: Diagnsis active: asymptmatic HIV ; OR: Diagnsis active: multiple myelma ; OR: Diagnsis active: leukemia ; OR: Medicatin allergy: VZV ; OR: Diagnsis active: immundeficiency ; AND: OR: >=3 cunt(s) f Medicatin administered: hepatitis B vaccine, ccurring < 2 years after Patient

7 OR: Diagnsis active: hepatitis B diagnsis ; OR: Diagnsis reslved: hepatitis B diagnsis ; OR: Substance allergy: Baker s yeast ; OR: Medicatin allergy: hepatitis B vaccine ; Numeratr 12 = AND: >= 4 cunt(s) f Medicatin administered: DTaP vaccine, different dates, ccurring >=42 OR: Medicatin allergy: DTaP vaccine ; OR: Diagnsis active: encephalpathy ; OR: Diagnsis active: prgressive neurlgical disrder ; AND: >=3 cunt(s) f Medicatin administered: IPV, different dates, ccurring >=42 OR: Medicatin allergy: IPV ; OR: Medicatin allergy: nemycin ; OR:: Medicatin allergy: streptmycin ; AND: Medicatin administered: MMR >=1, ccurring <2 years after the Patient OR: AND: >1 cunt(s) f Medicatin administered: mumps vaccine, ccurring <2 years after Patient Medicatin allergy: mumps vaccine ; AND: > 1 cunt(s) f Medicatin administered: measles vaccine, ccurring <2 years after Patient Medicatin allergy: measles vaccine ; AND: >1 cunt(s) f Medicatin administered: rubella vaccine, ccurring <2 years after Patient Medicatin allergy: rubella vaccine ; OR: Diagnsis reslved: measles ; AND: >1 cunt(s) f Medicatin administered: mumps vaccine, ccurring <2 years after Patient Medicatin allergy: mumps vaccine ; AND: >1 cunt(s) f Medicatin administered: rubella vaccine, ccurring <2 years after Patient Medicatin allergy: rubella vaccine ; OR: Diagnsis reslved: mumps ; AND: >1 cunt(s) f Medicatin administered: measles vaccine, ccurring <2 years after Patient

8 Medicatin allergy: measles vaccine ; AND: >1 cunt(s) f Medicatin administered: rubella vaccine, ccurring <2 years after Patient Medicatin allergy: rubella vaccine ; OR: Diagnsis reslved: rubella ; AND: >1 cunt(s) f Medicatin administered: mumps vaccine, ccurring <2 years after Patient Medicatin allergy: mumps vaccine ; AND: >1 cunt(s) f Medicatin administered: measles vaccine, ccurring <2 years after Patient Medicatin allergy: measles vaccine ; OR: Diagnsis active: cancer f lymphreticular r histicytic tissue ; OR: Diagnsis inactive: cancer f lymphreticular r histicytic tissue ; OR: Diagnsis active: asymptmatic HIV ; OR: Diagnsis active: multiple myelma ; OR: Diagnsis active: leukemia ; OR: Medicatin allergy: MMR ; OR: Diagnsis active: immundeficiency ; OR: Medicatin allergy: plymyxin ; AND: >=1 cunt(s) f Medicatin administered: VZV, ccurring < 2 years after Patient OR: Diagnsis reslved: VZV ; AND NOT OR: Diagnsis active: cancer f lymphreticular r histicytic tissue ; OR: Diagnsis inactive: cancer f lymphreticular r histicytic tissue ; OR: Diagnsis active: asymptmatic HIV ; OR: Diagnsis active: multiple myelma ; OR: Diagnsis active: leukemia ; OR: Medicatin allergy: VZV ; OR: Diagnsis active: immundeficiency ; AND: OR: >=3 cunt(s) f Medicatin administered: hepatitis B vaccine, ccurring < 2 years after Patient OR: Diagnsis reslved: hepatitis B diagnsis ; OR: Substance allergy: Baker s yeast ; OR: Medicatin allergy: hepatitis B vaccine ; AND: >=4 cunt(s) f Medicatin administered: pneumcccal vaccine, ccurring >=42 Medicatin allergy: pneumcccal vaccinatin ;

9 Exclusins = AND: Nne; Data criteria (QDS Data Elements) Initial Patient Ppulatin = "Patient characteristic: Birth date using birth date cde list befre the beginning f the measurement perid ; Denminatr = All patients in the initial patient ppulatin; Encunter: encunter utpatient w/pcp & bgyn using encunter utpatient w/pcp & bgyn cde list befre r simultaneusly t Numeratr = Medicatin allergy: DTaP using DTaP cde list befre r simultaneusly t the Medicatin allergy: nemycin using nemycin cde list befre measurement end Medicatin allergy: streptmycin using streptmycin cde list befre measurement end Medicatin allergy: plymyxin using plymyxin cde list befre measurement end Diagnsis active: encephalpathy using encephalpathy cde list gruping befre measurement end Diagnsis active: prgressive neurlgical disrder using prgressive neurlgical disrder befre measurement end Diagnsis active: cancer f lymphreticular r histicytic tissue using cancer f lymphreticular r histicytic tissue cde list gruping befre measurement end Diagnsis inactive: cancer f lymphreticular r histicytic disease using cancer f lymphreticular r histicytic tissue cde list gruping befre measurement end Diagnsis active: asymptmatic HIV using asymptmatic HIV cde list gruping befre measurement end Diagnsis active: multiple myelma using multiple myelma cde list gruping befre measurement end Diagnsis active: leukemia using leukemia cde list gruping befre measurement end Medicatin allergy: MMR using MMR cde list <=2 years befre measurement end Medicatin allergy: mumps vaccine using mumps vaccine cde list befre

10 Medicatin allergy: measles vaccine using measles vaccine cde list befre Medicatin allergy: VZV vaccine using VZV vaccine cde list befre measurement end Medicatin allergy: influenza vaccine using influenza vaccine cde list befre Substance allergy: Baker s yeast using Baker s yeast cde list befre measurement end Medicatin allergy: hepatitis B vaccine using hepatitis B vaccine cde list befre Medicatin allergy: hepatitis A vaccine using hepatitis A vaccine cde list befre Diagnsis reslved: hepatitis A diagnsis using hepatitis A diagnsis gruping cde list befre Medicatin allergy: rtavirus vaccine using rtavirus vaccine cde list befre Medicatin allergy: pneumcccal vaccine using pneumcccal vaccine cde list befre Medicatin allergy: HiB using HiB cde list befre Medicatin administered: DTaP using DTaP cde list befre the measurement end Medicatin administered: IPV using IPV cde list befre the measurement end Diagnsis reslved: measles using measles cde list gruping befre measurement end Diagnsis reslved: mumps using mumps cde list gruping befre measurement end Diagnsis reslved: rubella using rubella cde list gruping befre measurement end "Medicatin administered: MMR using MMR cde list befre the measurement end Medicatin administered: mumps vaccine using mumps vaccine cde list befre the Medicatin administered: measles vaccine using measles vaccine cde list befre the Medicatin administered: rubella vaccine using rubella vaccine cde list befre the "Medicatin administered: HiB using HiB cde list befre the measurement end Medicatin administered: hepatitis B vaccine using hepatitis B vaccine cde list befre the Diagnsis reslved: VZV using VZV cde list gruping befre the measurement end "Medicatin administered: VZV using VZV cde list befre the measurement end Medicatin administered: influenza vaccine using influenza vaccine cde list befre Diagnsis reslved: hepatitis B diagnsis using hepatitis B cde list gruping ;

11 Diagnsis active: hepatitis B diagnsis using hepatitis B cde list gruping ; "Medicatin administered: hepatitis A vaccine using hepatitis A vaccine cde list befre Medicatin administered: rtavirus vaccine using rtavirus vaccine cde list befre "Medicatin administered: pneumcccal vaccine using pneumcccal vaccine cde list befre Diagnsis active: immundeficiency using immundeficiency cde list gruping befre r simultaneusly t Exclusins = Nne; Summary calculatin Calculatin is generic t all measures: Calculate the final denminatr by adding all that meet denminatr criteria. Subtract frm the final denminatr all that d nt meet numeratr criteria yet als meet exclusin criteria. Nte sme measures d nt have exclusin criteria. The perfrmance calculatin is the number meeting numeratr criteria divided by the final denminatr. Fr measures with multiple patient ppulatins, repeat this prcess fr each patient ppulatin and reprt each result separately. Fr measures with multiple numeratrs, calculate each numeratr separately within each ppulatin using the paired exclusin. Measure set CLINICAL QUALITY MEASURE SET