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Measure Summary
Title
Chronic obstructive pulmonary disease (COPD): percentage of patients aged 18 years and older with a diagnosis of COPD who received a pneumococcus immunization.
Source(s)
Physician Consortium for Performance Improvement®. Clinical performance measures: chronic obstructive pulmonary disease (COPD). Tools developed by physicians for physicians. Chicago (IL): American Medical Association (AMA); 2006. 8 p. [12 references]

Measure Domain

Primary Measure Domain
Clinical Quality Measures: Process
Secondary Measure Domain
Does not apply to this measure

Brief Abstract

Description

This measure is used to assess the percentage of patients who received a pneumococcus immunization.

Rationale

According to the Advisory Committee on Immunization Practices, Centers for Disease Control and Prevention (CDC), all patients with chronic disease of the pulmonary system should be vaccinated.

Evidence for Rationale
Centers for Disease Control and Prevention, The Advisory Committee on Immunization Practices, US Department of Health and Human Services. Recommended adult immunization schedule October 2004-September 2005. MMWR Morb Mortal Wkly Rep. 2004;53(45):1-4.
Primary Health Components

Chronic obstructive pulmonary disease (COPD); pneumococcus immunization

Denominator Description

All patients aged 18 years and older with the diagnosis of chronic obstructive pulmonary disease (COPD) (see the related "Denominator Inclusions/Exclusions" field)

Numerator Description

All patients who are administered a pneumococcus immunization during a visit or who have already received a pneumococcus immunization

Evidence Supporting the Measure

Type of Evidence Supporting the Criterion of Quality for the Measure
  • A clinical practice guideline or other peer-reviewed synthesis of the clinical research evidence
  • One or more research studies published in a National Library of Medicine (NLM) indexed, peer-reviewed journal
Additional Information Supporting Need for the Measure
  • An estimated 12.1 million adults ages 25 and older are reported to have the diagnosis of chronic obstructive pulmonary disease (COPD). More than 50% of individuals with COPD did not receive a pneumococcus immunization.
  • Chronic obstructive pulmonary disease (COPD) is a slowly progressive disease impacting the nation's health. In the United States, COPD is the 4th leading cause of death.
  • Annually, 1.5 million emergency department visits are made for chronic obstructive pulmonary disease (COPD) and approximately 725,000 hospitalizations occur.
  • The total direct and indirect cost of chronic obstructive pulmonary disease (COPD) in 2002 are estimated to be $32.1 billion.
  • Overall poor quality for the performance measured
Evidence for Additional Information Supporting Need for the Measure
Dewan NA, Rafique S, Kanwar B, Satpathy H, Ryschon K, Tillotson GS, Niederman MS. Acute exacerbation of COPD: factors associated with poor treatment outcome. Chest. 2000 Mar;117(3):662-71. PubMed External Web Site Policy

National Heart, Lung, and Blood Institute. Chronic obstructive pulmonary disease data fact sheet. Bethesda (MD): US Department of Health and Human Services, NIH, NHLBI; 2003 Mar. 6 p.

National Heart, Lung, and Blood Institute. Morbidity and mortality: 2002 chartbook on cardiovascular, lung, and blood diseases. Bethesda (MD): US Department of Health and Human Services, NIH, NHLBI; 2002 May.
Extent of Measure Testing

Unspecified

State of Use of the Measure

State of Use
Current routine use
Current Use
Internal quality improvement
National reporting
Professional certification

Application of the Measure in its Current Use

Measurement Setting
Ambulatory/Office-based Care
Community Health Care
Managed Care Plans
Rural Health Care
Professionals Involved in Delivery of Health Services
Advanced Practice Nurses
Physician Assistants
Physicians
Least Aggregated Level of Services Delivery Addressed
Individual Clinicians or Public Health Professionals
Statement of Acceptable Minimum Sample Size
Does not apply to this measure
Target Population Age

Age greater than or equal to 18 years

Target Population Gender
Either male or female

National Strategy for Quality Improvement in Health Care

National Quality Strategy Aim
Better Care
National Quality Strategy Priority
Prevention and Treatment of Leading Causes of Mortality

Institute of Medicine (IOM) National Health Care Quality Report Categories

IOM Care Need
Living with Illness
IOM Domain
Effectiveness

Data Collection for the Measure

Case Finding Period

Unspecified

Denominator Sampling Frame
Patients associated with provider
Denominator (Index) Event or Characteristic
Clinical Condition
Patient/Individual (Consumer) Characteristic
Denominator Time Window
Does not apply to this measure
Denominator Inclusions/Exclusions

Inclusions
All patients aged 18 years and older with the diagnosis of chronic obstructive pulmonary disease (COPD)

Exclusions
Pneumococcus immunization recommended but not administered; documentation of medical reason(s) for not administering the pneumococcus immunization; documentation of patient reason(s) for not administering the pneumococcus immunization; documentation of system reason(s) for not administering the pneumococcus immunization

Exclusions/Exceptions
Medical factors addressed
Patient factors addressed
System factors addressed
Numerator Inclusions/Exclusions

Inclusions
All patients who are administered a pneumococcus immunization during a visit or who have already received a pneumococcus immunization

Exclusions
None

Numerator Search Strategy
Fixed time period or point in time
Data Source
Administrative clinical data
Paper medical record
Type of Health State
Does not apply to this measure
Instruments Used and/or Associated with the Measure

Chronic Obstructive Pulmonary Disease Core Physician Performance Measurement Set Data Collection Flowsheet

Computation of the Measure

Measure Specifies Disaggregation
Does not apply to this measure
Scoring
Rate/Proportion
Interpretation of Score
Desired value is a higher score
Allowance for Patient or Population Factors
Unspecified
Standard of Comparison
Internal time comparison

Identifying Information

Original Title

Pneumococcus immunization administered.

Submitter
American Medical Association on behalf of the Physician Consortium for Performance Improvement® - Medical Specialty Society
Developer
Physician Consortium for Performance Improvement® - Clinical Specialty Collaboration
Funding Source(s)

Unspecified

Composition of the Group that Developed the Measure

William E. Golden, MD, FACP (Co-Chair); Linus Santo Tomas, MD, MS (Co-Chair); Bruce Bagley, MD; Troy T. Fiesinger, MD; David G. Jaimovich, MD; Bruce Krieger, MD; Thomas W. Lukens, MD, PhD, FACEP; Sam J. W. Romeo, MD, MBA; Ralph M Schapira, MD; Sean D. Sullivan, RPh, PhD; Dennis E. Richling, MD; Deborah Patterson, RN

Mark S. Antman, DDS, MBA, American Medical Association; Karen S. Kmetik, PhD, American Medical Association

Becky Kresowik, Consultant; Tim Kresowik, MD, Consultant

Min Gayles Kim, MPH, National Committee for Quality Assurance

Nancy Lawler, RN, Joint Commission on Accreditation of Healthcare Organizations

Carla Herrerias, MPH, American College of Chest Physicians

Janet Leiker, RN, MPH, CPHQ, American Academy of Family Physicians

Nancy Stonis, RN, BSN, MJ, Society of Critical Care Medicine

LT Pauline Karikari-Martin, MPH, MSN, APRN, BC, PAHM, Centers for Medicare & Medicaid Services; Susan Nedza, MD, MBA, FACEP, Centers for Medicare & Medicaid Services

John M. Young, MS, Epidemiologist, Quality Measurement and Health Assessment Group

Financial Disclosures/Other Potential Conflicts of Interest

Conflicts, if any, are disclosed in accordance with the Physician Consortium for Performance Improvement® conflict of interest policy.

Adaptation

This measure was not adapted from another source.

Date of Most Current Version in NQMC
2006 Mar
Measure Maintenance

Unspecified

Date of Next Anticipated Revision

Unspecified

Measure Status

This is the current release of the measure.

The Physician Consortium for Performance Improvement reaffirmed the currency of this measure in November 2011.

Source(s)
Physician Consortium for Performance Improvement®. Clinical performance measures: chronic obstructive pulmonary disease (COPD). Tools developed by physicians for physicians. Chicago (IL): American Medical Association (AMA); 2006. 8 p. [12 references]
Measure Availability

The individual measure, "Pneumococcus immunization administered," is published in the "Clinical Performance Measures: Chronic Obstructive Pulmonary Disease (COPD)." This document and technical specifications are available in Portable Document Format (PDF) from the American Medical Association (AMA)-convened Physician Consortium for Performance Improvement® Web site: www.physicianconsortium.org External Web Site Policy.

For further information, please contact AMA staff by e-mail at cqi@ama-assn.org.

NQMC Status

This NQMC summary was completed by ECRI on August 28, 2006. The information was verified by the measure developer on July 6, 2007. This NQMC summary was retrofitted into the new template on August 5, 2011. The information was reaffirmed by the measure developer on November 30, 2011.

Copyright Statement

Physician Performance Measures (Measures) and related data specifications, developed by the Physician Consortium for Performance Improvement® (the Consortium), are intended to facilitate quality improvement activities by physicians.

These measures are intended to assist physicians in enhancing quality of care. Measures are designed for use by any physician who manages the care of a patient for a specific condition or for prevention. These performance measures are not clinical guidelines and do not establish a standard of medical care. The Consortium has not tested its measures for all potential applications. The Consortium encourages the testing and evaluation of its measures.

Measures are subject to review and may be revised or rescinded at any time by the Consortium. The measures may not be altered without the prior written approval of the Consortium. Measures developed by the Consortium, while copyrighted, can be reproduced and distributed, without modification, for noncommercial purposes, e.g., use by health care providers in connection with their practices. Commercial use is defined as the sale, license, or distribution of measures for commercial gain, or incorporation of the measures into a product or service that is sold, licensed or distributed for commercial gain. Commercial uses of the measures require a license agreement between the user and American Medical Association, on behalf of the Consortium. Neither the Consortium nor its members shall be responsible for any use of these measures.

THE MEASURES ARE PROVIDED "AS IS" WITHOUT WARRANTY OF ANY KIND.

© 2006 American Medical Association. All Rights Reserved.

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