Adult diabetes: percentage of eligible patients who received an immunization or Adults with diabetes account for more than 60% of nontraumatic lower limb …
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Complete Summary
TITLE
Adult diabetes: percentage of eligible patients who received an
immunization or refused immunization during the calendar period
SOURCES
National Diabetes Quality Improvement Alliance performance measurement
set for adult diabetes Chicago IL: National Diabetes Quality
Improvement Alliance; 2003 May 1 11 p
Measure Domain
PRIMARY MEASURE DOMAIN
Process
The validity of measures depends on how they are built By examining the
key building blocks of a measure, you can assess its validity for your
purpose For more information, visit the Measure Validity page
SECONDARY MEASURE DOMAIN
Does not apply to this measure
Brief Abstract
DESCRIPTION
This measure assesses the percentage of eligible adult diabetes patients
aged 18-75 years who received immunization or refused immunization during
the calendar period
This measure is used for the purpose of quality improvement
RATIONALE
Patients with diabetes are considered to be at increased risk for
complications, hospitalization, and death from influenza and
pneumococcal
disease
According to the Advisory Committee on Immunization Practices ACIP,
immunization for influenza is strongly recommended for any person 6
months of age or older who, because of age or underlying medical
condition, is at increased risk for complications of influenza
American Diabetes Association ADA recommends an influenza vaccine for
patients with diabetes, aged greater than or equal to 6 months, beginning
each September
PRIMARY CLINICAL COMPONENT
Diabetes mellitus; influenza immunization
DENOMINATOR DESCRIPTION
All patients diagnosed with diabetes aged 18-75 years
NUMERATOR DESCRIPTION
The number of patients from the denominator who received an immunization
or refused immunization during the calendar period
Evidence Supporting the Measure
EVIDENCE SUPPORTING THE CRITERION OF QUALITY
A clinical practice guideline or other peer-reviewed synthesis of the
clinical evidence
A formal consensus procedure involving experts in relevant clinical,
methodological, and organizational sciences
NATIONAL GUIDELINE CLEARINGHOUSE LINK
Using live, attenuated influenza vaccine for prevention
and control of
influenza: supplemental recommendations of the Advisory Committee on
Immunization Practices ACIP
Evidence Supporting Need for the Measure
NEED FOR THE MEASURE
Variation in quality for the performance measured
EVIDENCE SUPPORTING NEED FOR THE MEASURE
Bridges CB, Fukuda K, Cox NJ, Singleton JA Prevention and control of
influenza Recommendations of the Advisory Committee on Immunization
Practices ACIP MMWR Recomm Rep2001 Apr 20;50RR-4:1-44 [265
references] PubMed
Immunization and the prevention of influenza and pneumococcal disease in
people with diabetes Diabetes Care2002 Jan;25Suppl 1:S117-9 [24
references]
State of Use of the Measure
STATE OF USE
Current routine use
CURRENT USE
Internal quality improvement
Application of Measure in its Current Use
CARE SETTING
Ambulatory Care
Community Health Care
Managed Care Plans
Physician Group Practices/Clinics
Rural Health Care
PROFESSIONALS RESPONSIBLE FOR HEALTH CARE
Advanced Practice Nurses
Physician Assistants
Physicians
LOWEST LEVEL OF HEALTH CARE DELIVERY ADDRESSED
Individual
Clinicians
TARGET POPULATION AGE
Age 18-75 years
TARGET POPULATION GENDER
Either male or female
STRATIFICATION BY VULNERABLE POPULATIONS
Unspecified
Characteristics of the Primary Clinical Component
INCIDENCE/PREVALENCE
Total: 182 million people - 63 of the population - have diabetes
Diagnosed: 13 million people
Undiagnosed: 52 million people
New cases diagnosed per year: 13 million
About one third of these individuals do not know that they have the
disease
EVIDENCE FOR INCIDENCE/PREVALENCE
American Diabetes Association Diabetes statistics [internet]
Alexandria VA: American Diabetes Association; [accessed 2004 Jun 11]
[2 p]
National diabetes fact sheet: national estimates on diabetes [internet]
Atlanta GA: Centers for Disease Control and Prevention CDC, National
Center for Chronic Disease Prevention and Health Promotion; 2003[updated
2003 Dec 04]; [accessed 2004 Feb 01] [8 p]
ASSOCIATION WITH VULNERABLE POPULATIONS
Unspecified
BURDEN OF ILLNESS
Diabetes is the leading cause of end-stage renal disease, accounting
for 43 of new cases Adults with diabetes account for more than 60
of nontraumatic lower limb amputations and are also twice as likely to
have heart disease than people without diabetes
Diabetes is the sixth leading cause of death listed on US death
certificates in 2000 This is based on the 69,301 death certificates
in which diabetes was listed as the underlying cause of death
Altogether, diabetes contributed to 213,062 deaths
Complications from diabetes include hearth disease, stroke,
hypertension, retinopathy, end-stage renal disease, peripheral
neuropathy, non-traumatic lower limb amputations, periodontal disease,
pregnancy complications affecting mother and fetus, ketoacidosis, and
coma
Patients with diabetes are considered to be at increased risk for
complications, hospitalization, and death from influenza and
pneumococcal disease
EVIDENCE FOR BURDEN OF ILLNESS
American Diabetes Association Diabetes statistics [internet]
Alexandria VA: American Diabetes Association; [accessed 2004 Jun 11]
[2 p]
Immunization and the prevention of influenza and pneumococcal disease in
people with diabetes Diabetes Care2002 Jan;25Suppl 1:S117-9 [24
references]
National
diabetes fact sheet: national estimates on diabetes [internet]
Atlanta GA: Centers for Disease Control and Prevention CDC, National
Center for Chronic Disease Prevention and Health Promotion; 2003[updated
2003 Dec 04]; [accessed 2004 Feb 01] [8 p]
UTILIZATION
Unspecified
COSTS
2002 cost of diabetes in the United States: 132 billion
Direct medical costs: 92 billion
Indirect costs: 40 billion disability, work loss, premature
mortality
EVIDENCE FOR COSTS
American Diabetes Association Diabetes statistics [internet]
Alexandria VA: American Diabetes Association; [accessed 2004 Jun 11]
[2 p]
National diabetes fact sheet: national estimates on diabetes [internet]
Atlanta GA: Centers for Disease Control and Prevention CDC, National
Center for Chronic Disease Prevention and Health Promotion; 2003[updated
2003 Dec 04]; [accessed 2004 Feb 01] [8 p]
Institute of Medicine National Healthcare Quality Report Categories
IOM CARE NEED
Living with Illness
IOM DOMAIN
Effectiveness
Data Collection for the Measure
CASE FINDING
Users of care only
DESCRIPTION OF CASE FINDING
All patients diagnosed with
diabetes aged 18-75 years
DENOMINATOR SAMPLING FRAME
Patients associated with provider
DENOMINATOR INCLUSIONS/EXCLUSIONS
Inclusions
All patients diagnosed with diabetes aged 18-75 years
Exclusions
Documentation of medical reasons for not receiving influenza
immunization eg, allergy to eggs, drug interaction, contraindication
RELATIONSHIP OF DENOMINATOR TO NUMERATOR
All cases in the denominator are equally eligible to appear in the
numerator
DENOMINATOR INDEX EVENT
Clinical Condition
DENOMINATOR TIME WINDOW
Time window follows index event
NUMERATOR INCLUSIONS/EXCLUSIONS
Inclusions
The number of patients from the denominator who received an immunization
or refused immunization during the calendar period
Exclusions
None
MEASURE RESULTS UNDER CONTROL OF HEALTH CARE PROFESSIONALS, ORGANIZATIONS
AND/OR POLICYMAKERS
The measure results are somewhat or substantially under the control of
the health care professionals, organizations and/or policymakers to whom
the measure applies
NUMERATOR TIME WINDOW
Fixed time period
DATA SOURCE
Administrative data
Medical record
Pharmacy data
LEVEL OF DETERMINATION OF QUALITY
Individual Case
PRE-EXISTING INSTRUMENT USED
None
Computation of the Measure
SCORING
Rate
INTERPRETATION OF SCORE
Better quality is associated with a higher score
ALLOWANCE FOR PATIENT FACTORS
Unspecified
STANDARD OF COMPARISON
Internal time comparison
Evaluation of Measure Properties
EXTENT OF MEASURE TESTING
Unspecified
Identifying Information
ORIGINAL TITLE
Percentage of eligible patients who received an immunization or refused
immunization during the calendar period
MEASURE COLLECTION
National Diabetes Quality Improvement Alliance Performance Measures
MEASURE SET NAME
National Diabetes Quality Improvement Alliance Performance Measurement
Set for Adult Diabetes
DEVELOPER
National Diabetes Quality Improvement Alliance
FUNDING SOURCES
Unspecified
COMPOSITION OF THE GROUP THAT DEVELOPED THE MEASURE
National Committee for Quality Assurances NCQAs Measurement Advisory
Panels MAPs are composed of clinical and research experts with an
understanding of quality performance measurement in the particular
clinical content areas
FINANCIAL
DISCLOSURES/OTHER POTENTIAL CONFLICTS OF INTEREST
In order to fulfill National Committee for Quality Assurances NCQAs
mission and vision of improving health care quality through measurement,
transparency and accountability, all participants in NCQAs expert panels
are required to disclose potential conflicts of interest prior to their
participation The goal of this Conflict Policy is to ensure that
decisions which impact development of NCQAs products and services are
made as objectively as possible, without improper bias or influence
ADAPTATION
Measure was not adapted from another source
RELEASE DATE
2003 May
MEASURE STATUS
This is the current release of the measure
SOURCES
National Diabetes Quality Improvement Alliance performance measurement
set for adult diabetes Chicago IL: National Diabetes Quality
Improvement Alliance; 2003 May 1 11 p
MEASURE AVAILABILITY
The individual measure, Percentage of Eligible Patients Who Received an
Immunization or Refused Immunization During the Calendar Period, is
published in the National Diabetes Quality Improvement Alliance
Performance Measurement Set for Adult Diabetes This document is
available in Portable Document Format PDF from the National Diabetes
Quality Improvement Alliance Web site
NQMC STATUS
This NQMC summary was completed by ECRI on December 9, 2003 The
information was verified by the measure developer on August 19, 2004
COPYRIGHT STATEMENT
No copyright restrictions apply, however, the following disclaimer
pertains:
This document was developed and approved by the National Diabetes Quality
Improvement Alliance No other version of this document is approved by, or
may be presented as the work product of, the National Diabetes Quality
Improvement Alliance For more information about the National Diabetes
Quality Improvement Alliance, visit the Alliance home page at
wwwnationaldiabetesallianceorg
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2008 National Quality Measures Clearinghouse
Date Modified: 11/3/2008
