• Crisler KS, Hittle DF, Conway KS, West LR, Shaughnessy PW, Richard AA, Powell MC, Lawlor KL, Donelan-McCall NS, Beaudry JM, Baillie LL, Schlenker RE, Engle K. OASIS and outcome-based quality improvement in home health care: research and demonstration findings, policy implications, and considerations for future change. Vol. 3, Research and clinical supporting documents [9 supporting documents]. Denver (CO): Center for Health Services Research, University of Colorado Health Sciences Center; 2002 Feb 1.



• Hittle DF, Crisler KS, Beaudry JM, Conway KS, Shaughnessy PW, West LR, Richard AA. OASIS and outcome-based quality improvement in home health care: research and demonstration findings, policy implications, and considerations for future change. Vol. 4, OASIS chronicle and recommendations. Denver (CO): Center for Health Services Research, University of Colorado Health Sciences Center; 2002 Feb 1.



• Home health compare - data details. [internet]. Baltimore (MD): Centers for Medicare & Medicaid Services (CMS); [updated 2009 Nov 17]; [accessed 2004 Sep 29]. [9 p].



• Shaughnessy PW, Crisler KS, Hittle DF, Schlenker RE, Conway KS, West LR, Powell MC, Richard AA. OASIS and outcome-based quality improvement in home health care: research and demonstration findings, policy implications, and considerations for future change. Vol. 1, Policy and program overview. Denver (CO): Center for Health Services Research, University of Colorado Health Sciences Center; 2002 Feb 1.



• Shaughnessy PW, Hittle DF, Crisler KS, Powell MC, Richard AA, Kramer AM, Schlenker RE, Steiner JF, Donelan-McCall NS, Beaudry JM, Engle K, Conway KS, West LR. OASIS and outcome-based quality improvement in home health care: research and demonstration findings, policy implications, and considerations for future change. Vol. 2, Research and technical overview. Denver (CO): Center for Health Services Research, University of Colorado Health Sciences Center; 2002 Feb 1.

Does not apply to this measure

This measure is used to assess the percentage of home health care patients who improve in pain interfering with activity or movement compared to a prior assessment.

The measure identifies frequency with which pain interferes with patients' activities, taking into consideration any treatment that has been prescribed.

Pain is an important symptom for health care providers to investigate and to treat. Home health staff should determine whether a patient is having pain that interferes with activity at each visit. If the patient is having pain, they (or someone on their behalf) should tell the home health staff. The home health staff also should observe the patient to determine whether pain is present, even if it is not reported. Efforts can then be made to find and treat the cause and make the patient more comfortable. If pain that interferes with activity is not treated, the person may not be able to perform daily routines, may become depressed, or have an overall poor quality of life. Pain may also be a sign of a new or worsening health problem.

If patents have less pain interfering with activity, it may mean that the home health agency is doing a good job in assessing and treating their pain. Some patients' pain will be extremely difficult to adequately treat, even though the home health care agency provides good care.

This is one of 41 OASIS-based measures for which Medicare-certified home health agencies receive performance reports from the Centers for Medicare & Medicaid Services (CMS). The reports cover Medicare and Medicaid adult non-maternity patients and compare each agency's rates to national reference rates and to the agency's own rates in the previous year. The reports provide home health agencies with information they can use to improve quality of care by targeting care practices that influence specific patient functioning and health status, as part of a comprehensive quality improvement approach.

This measure is also one of ten Home Health Quality Initiative measures; a resource to help consumers compare home health agencies, and they are intended to motivate home health agencies to improve care and to inform discussions about quality between consumers and clinicians.

Home health care; pain; activity/movement

All patients with a completed home health episode of care (except those defined in the denominator exclusion) who were eligible to improve in pain interfering with activity or movement (i.e., were not at the optimal level of health status according to the "Frequency of Pain" OASIS* item) (see the related "Denominator Inclusions/Exclusions" field in the Complete Summary)

*Outcome and Assessment Information Set

Patients from the denominator who improved in pain interfering with activity or movement compared to a prior assessment (see the related "Numerator Inclusions/Exclusions" field in the Complete Summary)

Special or unique data

Improvement in pain interfering with activity.

Centers for Medicare & Medicaid Services

Center for Health Services Research, University of Colorado, under contract to Centers for Medicare and Medicaid Services

Centers for Medicare & Medicaid Services

Robert Wood Johnson Foundation

New York State Department of Health

Peter W. Shaughnessy, PhD; Kathryn S. Crisler, MS, RN; Robert E. Schlenker, PhD; David F. Hittle, PhD; Martha C. Powell, PhD; Angela Arnold Richard, MS, RN; Andrew M. Kramer, MD; Eugene J. Nuccio, PhD; and other staff of the Center for Health Services Research, University of Colorado

None apply

National Quality Forum

Home Health Compare
National Healthcare Disparities Report (NHDR)
National Healthcare Quality Report (NHQR)

Measure was not adapted from another source.

1998 Oct

2002 Feb

This is the current release of the measure.

• Crisler KS, Hittle DF, Conway KS, West LR, Shaughnessy PW, Richard AA, Powell MC, Lawlor KL, Donelan-McCall NS, Beaudry JM, Baillie LL, Schlenker RE, Engle K. OASIS and outcome-based quality improvement in home health care: research and demonstration findings, policy implications, and considerations for future change. Vol. 3, Research and clinical supporting documents [9 supporting documents]. Denver (CO): Center for Health Services Research, University of Colorado Health Sciences Center; 2002 Feb 1.



• Hittle DF, Crisler KS, Beaudry JM, Conway KS, Shaughnessy PW, West LR, Richard AA. OASIS and outcome-based quality improvement in home health care: research and demonstration findings, policy implications, and considerations for future change. Vol. 4, OASIS chronicle and recommendations. Denver (CO): Center for Health Services Research, University of Colorado Health Sciences Center; 2002 Feb 1.



• Home health compare - data details. [internet]. Baltimore (MD): Centers for Medicare & Medicaid Services (CMS); [updated 2009 Nov 17]; [accessed 2004 Sep 29]. [9 p].



• Shaughnessy PW, Crisler KS, Hittle DF, Schlenker RE, Conway KS, West LR, Powell MC, Richard AA. OASIS and outcome-based quality improvement in home health care: research and demonstration findings, policy implications, and considerations for future change. Vol. 1, Policy and program overview. Denver (CO): Center for Health Services Research, University of Colorado Health Sciences Center; 2002 Feb 1.



• Shaughnessy PW, Hittle DF, Crisler KS, Powell MC, Richard AA, Kramer AM, Schlenker RE, Steiner JF, Donelan-McCall NS, Beaudry JM, Engle K, Conway KS, West LR. OASIS and outcome-based quality improvement in home health care: research and demonstration findings, policy implications, and considerations for future change. Vol. 2, Research and technical overview. Denver (CO): Center for Health Services Research, University of Colorado Health Sciences Center; 2002 Feb 1.

The individual measure, "Improvement in Pain Interfering with Activity," is published in "OASIS and Outcome-Based Quality Improvement in Home Health Care: Research and Demonstration Findings, Policy Implications, and Considerations for Future Change. Volumes 1-4."

This NQMC summary was completed by ECRI on October 5, 2004. The information was verified by the measure developer on December 17, 2004 and was reviewed and edited on September 26, 2005.

No copyright restrictions apply.