Abstract 306: Guideline-based Strategies for Improving Control of High Blood Pressure: The 2019 Acc/Aha Performance and Quality Measures for Adults With High Blood Pressure

2020 ◽  
Vol 13 (Suppl_1) ◽  
Author(s):  
Donald E Casey
Keyword(s):  
Blood Pressure ◽  
Quality Of Care ◽  
High Blood Pressure ◽  
Clinical Performance ◽  
Quality Measures ◽  
Structural Quality ◽  
Fee For Service ◽  
And Control ◽  
Detection Evaluation

Despite a 27% reduction in all-cause mortality from targeting a systolic blood pressure of &lt 120 mm Hg, as compared with &lt 140 mm Hg, existing quality measures from the NCQA for controlling HBP (for hypertensive adults 18-59 years of age whose blood pressure was &lt 140/90 mm Hg) have not changed substantially over the past several years for a variety of insured populations, including commercial, Medicaid, Medicare Fee for Service and Medicare Advantage. Re-examining both the targets and processes of managing HBP are thus warranted to help support the use of the latest evidence in optimizing the quality of care and outcomes for patients with HBP. The recently published 2019 ACC/AHA Clinical Performance and Quality Measures for Adults with High Blood Pressure are designed to promote improvements in diagnosis and control of high blood pressure, including a new emphasis on “structural” quality measures that focus on a comprehensive system of care as outlined in the 2017 2017 ACC/AHA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults. The purpose of this presentation will be to provide a detailed overview of this new measure set as a “Blueprint for Change” necessary to overcome current health system inertia and ensure the achievement of better quality of care for people with High Blood Pressure.

scholarly journals 2019 AHA/ACC Clinical Performance and Quality Measures for Adults With High Blood Pressure

2019 ◽  
Vol 74 (21) ◽  
pp. 2661-2706 ◽  
Author(s):  
Donald E. Casey ◽  
Randal J. Thomas ◽  
Vivek Bhalla ◽  
Yvonne Commodore-Mensah ◽  
Paul A. Heidenreich ◽  
...  
Keyword(s):  
Blood Pressure ◽  
High Blood Pressure ◽  
Clinical Performance ◽  
Quality Measures

P-138: Factors affecting the quality of care among high blood pressure diabetic patients in Tunisia

2015 ◽  
Vol 64 ◽  
pp. S70
Author(s):  
M. Ben Cheikh ◽  
M. Omri ◽  
S. Mhidhli ◽  
T. Harrabi ◽  
H. Mhalla ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Quality Of Care ◽  
High Blood Pressure ◽  
Diabetic Patients ◽  
Factors Affecting

scholarly journals Quality of Care for Comorbid Conditions During the Transition to Survivorship: Differences Between Cancer Survivors and Noncancer Controls

2013 ◽  
Vol 31 (9) ◽  
pp. 1140-1148 ◽  
Author(s):  
Claire F. Snyder ◽  
Kevin D. Frick ◽  
Robert J. Herbert ◽  
Amanda L. Blackford ◽  
Bridget A. Neville ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Quality Of Care ◽  
Cancer Survivors ◽  
Breast Cancer Survivors ◽  
Care Quality ◽  
Comorbid Condition ◽  
Cancer Type ◽  
Fee For Service ◽  
To Receive

Purpose Building on previous research documenting differences in preventive care quality between cancer survivors and noncancer controls, this study examines comorbid condition care. Methods Using data from the Surveillance, Epidemiology, and End Results (SEER) –Medicare database, we examined comorbid condition quality of care in patients with locoregional breast, prostate, or colorectal cancer diagnosed in 2004 who were age ≥ 66 years at diagnosis, who had survived ≥ 3 years, and who were enrolled in fee-for-service Medicare. Controls were frequency matched to cases on age, sex, race, and region. Quality of care was assessed from day 366 through day 1,095 postdiagnosis using published indicators of chronic (n = 10) and acute (n = 19) condition care. The proportion of eligible cancer survivors and controls who received recommended care was compared by using Fisher's exact tests. The chronic and acute indicators, respectively, were then combined into single logistic regression models for each cancer type to compare survivors' care receipt to that of controls, adjusting for clinical and sociodemographic variables and controlling for within-patient variation. Results The sample matched 8,661 cancer survivors to 17,322 controls (mean age, 75 years; 65% male; 85% white). Colorectal cancer survivors were less likely than controls to receive appropriate care on both the chronic (odds ratio [OR], 0.88; 95% CI, 0.81 to 0.95) and acute (OR, 0.72; 95% CI, 0.61 to 0.85) indicators. Prostate cancer survivors were more likely to receive appropriate chronic care (OR, 1.28; 95% CI, 1.19 to 1.38) but less likely to receive quality acute care (OR, 0.75; 95% CI, 0.65 to 0.87). Breast cancer survivors received care equivalent to controls on both the chronic (OR, 1.06; 95% CI, 0.96 to 1.17) and acute (OR, 0.92; 95% CI, 0.76 to 1.13) indicators. Conclusion Because we found differences by cancer type, research exploring factors associated with these differences in care quality is needed.

scholarly journals Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure

Hypertension ◽  
2003 ◽  
Vol 42 (6) ◽  
pp. 1206-1252 ◽  
Author(s):  
Aram V. Chobanian ◽  
George L. Bakris ◽  
Henry R. Black ◽  
William C. Cushman ◽  
Lee A. Green ◽  
...  
Keyword(s):  
Blood Pressure ◽  
High Blood Pressure ◽  
Joint National Committee ◽  
National Committee ◽  
Seventh Report ◽  
Detection Evaluation

National benchmarks and practice level variation on eight cross cutting quality measures.

2021 ◽  
Vol 39 (28_suppl) ◽  
pp. 255-255
Author(s):  
Tracy E. Spinks ◽  
Lindsey Bandini ◽  
Amie Cook ◽  
Hong Gao ◽  
Nicholas Jennings ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Performance Status ◽  
Gynecologic Oncology ◽  
Quality Measures ◽  
Surgical Oncology ◽  
Small Sample ◽  
Prior Authorization ◽  
Level Variation ◽  
Practice Level

255 Background: While there is increased attention on the importance of quality measurement in oncology, especially with the rise of value-based payment, limited data exist on national averages and practice level variation for proposed quality measures to establish benchmarks and targets for quality improvement initiatives or value-based contracts. Methods: UnitedHealthcare (UHC) developed peer comparison reports for eight cross cutting quality measures for practices with an active contract for at least one of its commercial, Medicare or Medicaid health plans and ≥1 provider from the following specialties: gynecologic oncology, hematology/oncology, pediatric hematology/oncology, radiation oncology, or surgical oncology. Adherence to the quality measures below was calculated using a mix of claims data, clinical data from a prior authorization for cancer therapy, and CMS MIPS data. Patients were attributed through an algorithm that selected the most probable physician responsible for the patient’s care - responsible prior authorization provider, servicing provider or most recent visited provider prior to the treatment, varying by each measure. Dates of service differ by measure, ranging from 1/1/2019 through 12/31/2020. Results: We identified 5,828 unique tax identification numbers (TINs) with UHC members with cancer attributed to them during 2019-20. The number of practices included in the measurement cohort per measure varied significantly from 301 to 4,120 (tobacco screening and performance status, respectively). 2,422 TINs met the minimum patient count for at least one measure (≥10 patients or events). Overall performance ranged from 13.5% to 77.3% (hospice admission and PS documented) for measures where higher adherence reflects better quality of care. For measures where lower scores represent higher quality of care the range was 11.4% to 22.6% (hospice < 3 days and ED admission, respectively). Observed adherence was statistically better than expected for 0.5%-5.8% and statistically less than expected for 0.9%-5.6% of TINs in UHC’s network; however, more than half of the practices had insufficient sample size to make a determination. Conclusions: We observed substantial variation in quality across a national cohort of oncology practices. However, even for a large national payer, small sample sizes limited the assessment of a substantial number of practices.[Table: see text]

Abstract 3023: The Association of Insurance Status, Quality of Care, and In-Hospital Outcomes among Patients Hospitalized with Intracerebral Hemorrhage: Findings from GWTG-Stroke

Stroke ◽  
2012 ◽  
Vol 43 (suppl_1) ◽  
Author(s):  
Michael L James ◽  
Julian P Yand ◽  
Maria Grau-Sepulveda ◽  
DaiWai M Olson ◽  
Deepak L Bhatt ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Length Of Stay ◽  
Intracerebral Hemorrhage ◽  
Reference Group ◽  
Private Insurance ◽  
Quality Measures ◽  
Geographic Region ◽  
Insurance Status ◽  
Hospital Outcomes

Introduction Intracerebral hemorrhage (ICH) can be a devastating condition, requiring intensive intervention. Yet, few studies have examined whether patient insurance status is associated with ICH care or acute outcomes. Methods Using data from 1,711 sites participating in GWTG-Stroke database from April 2003 to April 2011, we identified 156,848 non-transferred subjects with ICH who had known discharge status. Insurance status was categorized as private, Medicaid, Medicare or none. We explored associations between lack of insurance (using private insurance status as the reference group) and in-hospital outcomes (mortality, ambulatory status, & length of stay) and quality of care measures (DVT prophylaxis, smoking cessation, dysphagia screening, stroke education, imaging times, & rehabilitation). We utilized multiple individual (including demographics and medical history) and hospital (including size, geographic region and academic teaching status)lcharacteristics as covariates. Results Subjects without insurance (n=10647) were younger (54.4 v. 71 years), more likely men (60.6 v. 50.8%), more likely black (33.2 v. 17.4%) or Hispanic (15.8 v. 7.9%), from the South (50.6 v. 38.9%), and had fewer vascular risk factors with the exception of smoking when compared with the overall subject population. Further, subjects without insurance were more likely to experience in-hospital mortality (25.9 v. 23.9%; adjusted OR 1.29) and longer length of stay (11.4 v. 7.8 days), but were more likely to receive all quality measures of care, be discharged home (52.1 v. 36.1%), and ambulate independently (47.5 v. 38.5%) at discharge compared with subjects with private insurance (n=40033). Conclusions Among GWTG-Stroke participating hospitals, ICH patients without insurance were more likely to die while in the hospital but experienced higher quality measures of care and were more likely to ambulate independently at discharge should they survive.

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