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J Manag Care Spec Pharm. 2015 Nov;21(11):1064-76. doi: 10.18553/jmcp.2015.21.11.1064.
Inflammatory bowel disease (IBD) is a chronic relapsing disease characterized by activation of the mucosal immune system and inflammation of the gastrointestinal tract. Management of IBD places a significant burden on the health care system because of the complexity of treatment, variability in patient outcomes, and chronic nature of the disease.
To investigate the American Gastroenterological Association (AGA) and Crohn's and Colitis Foundation of America's (CCFA) quality measurement sets in a sample of IBD patients.
Fourteen quality measures were restated for application to a claims database and calculated using Optum Clinformatics DataMart database. Selected measures were calculated over calendar year 2011.
Performance measures ranged from 0.4% for AGA measure 9, prophylaxis for venous thromboembolism, to 66.9% for AGA measure 8, testing for Clostridium difficile. CCFA outcome measures ranged from 0.6% qualifying for CCFA O10, report of fecal incontinence, to 32.9% for CCFA O1, prednisone usage. In addition to Clostridium difficile testing, the use of appropriate corticosteroid-sparing therapy (51.1%) and testing for latent tuberculosis before initiating anti-tumor necrosis factor therapy (45.0%) were the highest achieved measures.
This is the first examination of IBD quality measures using administrative claims. Rates of achievement across measures were variable and likely affected by the ability to calculate certain measures with claims data. Future studies should further examine measurement of IBD quality indicators in claims data to assess the validity of claims-based analyses and to ascertain whether measure attainment translates into better overall health or IBD-related outcomes.
炎症性肠病(IBD)是一种慢性复发性疾病,其特征为黏膜免疫系统激活和胃肠道炎症。由于治疗的复杂性、患者结局的可变性以及疾病的慢性性质,IBD 的管理给医疗保健系统带来了巨大负担。
在 IBD 患者样本中调查美国胃肠病学会(AGA)和美国克罗恩病和结肠炎基金会(CCFA)的质量测量集。
将 14 项质量措施重新表述为适用于索赔数据库的措施,并使用 Optum Clinformatics DataMart 数据库进行计算。选择的措施在 2011 日历年内进行计算。
性能指标的范围从 AGA 措施 9(预防静脉血栓栓塞症)的 0.4%到 AGA 措施 8(检测艰难梭菌)的 66.9%。CCFA 结局指标的范围从 CCFA O10(报告粪便失禁)的 0.6%到 CCFA O1(使用泼尼松)的 32.9%。除了艰难梭菌检测外,适当的皮质类固醇节约疗法的使用(51.1%)和在开始使用抗肿瘤坏死因子治疗之前检测潜伏性结核病(45.0%)是最高的达成措施。
这是首次使用行政索赔数据检查 IBD 质量措施。各项措施的达标率各不相同,这可能受到使用索赔数据计算某些措施的能力的影响。未来的研究应进一步研究索赔数据中 IBD 质量指标的测量,以评估索赔分析的有效性,并确定措施的实现是否转化为更好的整体健康或 IBD 相关结局。