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Putting Measurement to Work: Improving the Quality of Health Care Delivered to Adults
Where Can We Find Data?
Carla Zema, Kerr White Visiting Scholar, Agency for Healthcare Research and Quality (AHRQ).
Dr. Foster Gesten, Medical Director, Office of Managed Care, New York Department of Health (DOH).
Dr. Anne Elixhauser, Senior Social Science Analyst, Agency for Healthcare Research and Quality (AHRQ).
According to Ms. Zema, several national databases can be used to examine some aspects of care delivery and provide comparative information about performance.
Some of these databases can help identify and prioritize areas of concern that need further examination. Others can be used to judge whether a plan's or provider's performance is adequate, without further investigation. Three of these databases were discussed at the workshop.
- NMHBP, according to Dr. Gesten, Chair of the NMHBP steering committee, has three years of data from Medicaid contracted health plans on a number of Health Plan Employer Data and Information Set (HEDIS) performance measures, including a subset of nine measures chosen for benchmarking purposes. The database represents one primary care case management (PCCM) program and 169 plans serving a total of about 7 million Medicaid beneficiaries. Unreliable data is excluded.
- HCUP, according to Dr. Elixhauser, is a uniform database containing data about inpatient discharges, used for cross-State study. The calendar year 2000 data (from 31 States) includes 80 percent of all discharges in the U.S. AHRQ maintains the database and developed quality indicators for the HCUP. Quality indicators are easily produced measures for examining health outcomes, utilization, and primary care access. New quality indicators examining quality, prevention, and patient safety are in development.
- NCBD, according to Ms. Zema, is a national repository for CAHPS® data. CAHPS® is a consumer survey developed by AHRQ for measuring consumers' experiences with their health plans. It includes results for Medicaid, Medicare, and commercial populations that can be used for national and regional benchmarking. Customized reports can also be prepared for database contributors.
States also maintain databases that can provide useful information about hospital discharges, births, and deaths. Some information can also be obtained from public health surveillance efforts. However, not all States maintain all types of data, nor is the data always readily available.
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