The Potential Effects Of HEDIS Performance Measures On The Quality Of Care

Eddy, David M.; Pawlson, L. Gregory; Schaaf, David; Peskin, Barbara; Shcheprov, A. V.; Dziuba, Julia; Bowman, J. Beatrice; Eng, Benjamin

doi:10.1377/hlthaff.27.5.1429

Cited by 25 publications

(18 citation statements)

References 5 publications

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“…While speculative, the observed leveling of race/ethnicity-based differences in UACR testing in the presence of diabetes may be attributable to the national Healthcare Employer Data and Information Set (HEDIS) and NCQA measures that recommend annual assessment of renal function, including UACR, in individuals with diabetes [10]. A prior study found key improvements in completion of quality metrics before versus after HEDIS implementation, suggesting that almost half of U.S. adults benefited from improved performance on at least one HEDIS quality measure after HEDIS implementation, regardless of race/ethnicity [22]. Furthermore, data from the 2015 National Impact Assessment of Quality Measures Report identified several improvements in racial/ethnic disparities upon the implementation of HEDIS measures.…”

Section: Discussionmentioning

confidence: 99%

Albuminuria Testing by Race and Ethnicity among Patients with Hypertension with and without Diabetes

et al. 2019

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Background: Detection of chronic kidney disease (CKD) with urine albumin-to-creatinine ratio (UACR) among patients with hypertension (HTN) provides an opportunity for early treatment, potentially mitigating risk of CKD progression and cardiovascular complications. Differences in UACR testing patterns among racial/ethnic populations at risk for CKD could contribute to known disparities in CKD complications. Methods: We examined the prevalence of UACR testing among low-income adult primary care patients with HTN, defined by a new administrative code for HTN or 2 clinic blood pressures >140/90 mm Hg between January 1, 2014, and January 1, 2017, in one public health-care delivery system with a high prevalence of end-stage kidney disease among race/ethnic minorities. Logistic regression was used to identify odds of UACR testing within 1 year of a HTN diagnosis, overall, and by racial/ethnic subgroup, adjusted for demographic factors, estimated glomerular filtration rate, and HTN severity. Models were also stratified by diabetes status. Results: The cohort (n = 16,414) was racially/ethnically diverse (16% White, 21% Black, 34% Asian, 19% Hispanic, and 10% other) and 51% female. Only 35% of patients had UACR testing within 1 year of a HTN diagnosis. Among individuals without diabetes, odds of UACR testing were higher among Asians, Blacks, and Other subgroups compared to Whites (adjusted OR [aOR] 1.19; 95% CI 1.00–1.42 for Blacks; aOR 1.33; 1.13–1.56 for Asians; aOR 1.30; 1.04–1.60 for Other) but were not significantly different between Hispanics and Whites (aOR 1.17; 0.97–1.39). Among individuals with diabetes, only Asians had higher odds of UACR testing compared to Whites (aOR 1.35; 1.12–1.63). Conclusions: Prevalence of UACR testing among low-income patients with HTN is low in one public health-care delivery system, with higher odds of UACR testing among racial/ethnic minority subgroups compared to Whites without diabetes and similar odds among those with diabetes. If generalizable, less albuminuria testing may not explain higher prevalence of kidney failure in racial/ethnic minorities.

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Section: Discussionmentioning

confidence: 99%

Albuminuria Testing by Race and Ethnicity among Patients with Hypertension with and without Diabetes

et al. 2019

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“…Medical records will be the source of information about these commonly used intermediate outcome measures for diabetes [26,27]. …”

Section: Methodsmentioning

confidence: 99%

The impact of decision aids to enhance shared decision making for diabetes (the DAD study): protocol of a cluster randomized trial

LeBlanc

Ruud

Branda

et al. 2012

BMC Health Serv Res

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BackgroundShared decision making contributes to high quality healthcare by promoting a patient-centered approach. Patient involvement in selecting the components of a diabetes medication program that best match the patient’s values and preferences may also enhance medication adherence and improve outcomes. Decision aids are tools designed to involve patients in shared decision making, but their adoption in practice has been limited. In this study, we propose to obtain a preliminary estimate of the impact of patient decision aids vs. usual care on measures of patient involvement in decision making, diabetes care processes, medication adherence, glycemic and cardiovascular risk factor control, and resource utilization. In addition, we propose to identify, describe, and explain factors that promote or inhibit the routine embedding of decision aids in practice.Methods/DesignWe will be conducting a mixed-methods study comprised of a cluster-randomized, practical, multicentered trial enrolling clinicians and their patients (n = 240) with type 2 diabetes from rural and suburban primary care practices (n = 8), with an embedded qualitative study to examine factors that influence the incorporation of decision aids into routine practice. The intervention will consist of the use of a decision aid (Statin Choice and Aspirin Choice, or Diabetes Medication Choice) during the clinical encounter. The qualitative study will include analysis of video recordings of clinical encounters and in-depth, semi-structured interviews with participating patients, clinicians, and clinic support staff, in both trial arms.DiscussionUpon completion of this trial, we will have new knowledge about the effectiveness of diabetes decision aids in these practices. We will also better understand the factors that promote or inhibit the successful implementation and normalization of medication choice decision aids in the care of chronic patients in primary care practices.Trial registrationNCT00388050

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“…Monitoring and public reporting of blood pressure control for patients with hypertension in commercial and Medicare patients also helped to enhance health plan and physician awareness of blood pressure control. (3) Between 1999 and 2004, blood pressure control improved in U.S. adults with hypertension. (4–6)…”

Section: Introductionmentioning

confidence: 99%

Trends in Time to Confirmation and Recognition of New-Onset Hypertension, 2002–2006

et al. 2010

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The Potential Effects Of HEDIS Performance Measures On The Quality Of Care

Cited by 25 publications

References 5 publications

Albuminuria Testing by Race and Ethnicity among Patients with Hypertension with and without Diabetes

Albuminuria Testing by Race and Ethnicity among Patients with Hypertension with and without Diabetes

The impact of decision aids to enhance shared decision making for diabetes (the DAD study): protocol of a cluster randomized trial

Trends in Time to Confirmation and Recognition of New-Onset Hypertension, 2002–2006

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