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## Complete Summary

#### TITLE

HIV: percentage of pediatric patients for whom DTaP, IPV, HIB, Hep B,
MMR, pneumococcal, (and varicella, if asymptomatic and immunologic
class 1) are provided.

#### SOURCE(S)

New York State Department of Health AIDS Institute HIV Quality of Care
Program. Pediatric indicators. \[internet\]. New York: New York State
Department of Health AIDS Institute; 2000-2004 \[cited 2005 Aug 10\].
\[2 p\]. Available: http://www.hivguidelines.org/Content.aspx?PageID=37.

### 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](http://www.qualitymeasures.ahrq.gov/resources/measure_domains.aspx)
page.

#### SECONDARY MEASURE DOMAIN

Does not apply to this measure

### Brief Abstract

#### DESCRIPTION

This measure is used to assess the percentage of pediatric HIV-infected
patients for whom diphtheria/tetanus/acellular pertussis vaccine (DTaP),
inactivated poliovirus vaccine (IPV), *Haemophilus influenzae* type b
vaccine (HIB), hepatitis B vaccine (Hep B), measles/mumps/rubella
vaccine (MMR), pneumococcal, (and varicella, if asymptomatic and
immunologic class 1) are provided.

This measure is one of 12 New York State Department of Health AIDS
Institute, HIV Quality of Care Program, [Pediatric
Indicators](http://www.qualitymeasures.ahrq.gov/browse/DisplayOrganization.aspx?org_id=1781&doc=8358#data).

#### RATIONALE

The AIDS Institute is committed to promoting, monitoring and supporting
the quality of HIV clinical services for people with HIV in New York
State. Clinical guidelines are developed in accordance with newly
emerging clinical and research developments. By developing indicators
based on the guidelines, the AIDS Institute has created a mechanism for
measurement of HIV clinical performance.

These indicators measure critical aspects of the HIV Clinical Management
for pediatric HIV-infected patients.

**Note**: Although developed in New York State, these indicators are
intended to be used by clinicians caring for patients with HIV in an
ambulatory care setting in any locale.

#### PRIMARY CLINICAL COMPONENT

HIV; immunization (diphtheria/tetanus/acellular pertussis \[DTaP\]
vaccine, inactivated poliovirus \[IPV\] vaccine, *Haemophilus
influenzae* type b \[HIB\] vaccine, hepatitis B \[Hep B\] vaccine,
measles/mumps/rubella \[MMR\] vaccine, pneumococcal vaccine, varicella
vaccine)

#### DENOMINATOR DESCRIPTION

All pediatric HIV-infected patients according to immunization schedule
(see the related \"Denominator Inclusions/Exclusions\" field in the
Complete Summary)

#### NUMERATOR DESCRIPTION

The number of patients for whom diphtheria/tetanus/acellular pertussis
(DTaP) vaccine, inactivated poliovirus (IPV) vaccine, *Haemophilus
influenzae* type b (HIB) vaccine, hepatitis B (Hep B) vaccine,
measles/mumps/rubella (MMR) vaccine, pneumococcal vaccine, (and
varicella vaccine, if asymptomatic and immunologic class 1) are provided

### 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

### Evidence Supporting Need for the Measure

#### NEED FOR THE MEASURE

Use of this measure to improve performance

#### EVIDENCE SUPPORTING NEED FOR THE MEASURE

New York State Department of Health AIDS Institute. Clinical management
of HIV infection. Quality of care performance in New York State
1999-2001. New York: New York Department of Health AIDS Institute; 2003
Sep 1. 62 p.

### 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

#### PROFESSIONALS RESPONSIBLE FOR HEALTH CARE

Advanced Practice Nurses\
Physician Assistants\
Physicians

#### LOWEST LEVEL OF HEALTH CARE DELIVERY ADDRESSED

Individual Clinicians

#### TARGET POPULATION AGE

Ages 6 months to 13 years

#### TARGET POPULATION GENDER

Either male or female

#### STRATIFICATION BY VULNERABLE POPULATIONS

Unspecified

### Characteristics of the Primary Clinical Component

#### INCIDENCE/PREVALENCE

More than 6,000 children younger than age 13 at diagnosis are estimated
to be living with HIV/AIDS in the United States.

#### EVIDENCE FOR INCIDENCE/PREVALENCE

Centers for Disease Control and Prevention. HIV/AIDS surveillance
report, 2004. Vol. 16.Atlanta (GA): US Department of Health and Human
Services, Centers for Disease Control and Prevention; 2005. 46 p.

#### ASSOCIATION WITH VULNERABLE POPULATIONS

Minority and risk groups, including poverty populations, medically
uninsured, immigrants, and homeless persons

#### EVIDENCE FOR ASSOCIATION WITH VULNERABLE POPULATIONS

Centers for Disease Control and Prevention. HIV/AIDS surveillance
report, 2004. Vol. 16.Atlanta (GA): US Department of Health and Human
Services, Centers for Disease Control and Prevention; 2005. 46 p.

#### BURDEN OF ILLNESS

Unspecified

#### UTILIZATION

Unspecified

#### COSTS

Unspecified

### 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 HIV patients aged 6 months to 13 years\*

\*During the quality of care reviews a more selective criteria is
applied in determining which cases are reviewed: for the pediatric
indicators it is all pediatric HIV-infected patients with one primary
care visit in the last six months of the calendar year of review.

#### DENOMINATOR SAMPLING FRAME

Patients associated with provider

#### DENOMINATOR INCLUSIONS/EXCLUSIONS

**Inclusions**\
All pediatric HIV-infected patients according to immunization schedule\*

\*Immunization schedule is available at [CDC Web
site](http://www2a.cdc.gov/nip/count/CountVAC.asp?id=child-schedule-fourpages-print.pdf).

**Exclusions**

-   Patients with no medical visits occurring in last 6 months of year

-   Patients less than 6 months and greater than 13 years of age

#### RELATIONSHIP OF DENOMINATOR TO NUMERATOR

All cases in the denominator are equally eligible to appear in the
numerator

#### DENOMINATOR (INDEX) EVENT 

Clinical Condition\
Encounter

#### DENOMINATOR TIME WINDOW

Time window precedes index event

#### NUMERATOR INCLUSIONS/EXCLUSIONS

**Inclusions**\
The number of patients for whom diphtheria/tetanus/acellular pertussis
(DTaP) vaccine, inactivated poliovirus (IPV) vaccine, *Haemophilus
influenzae* type b (HIB) vaccine, hepatitis B (Hep B) vaccine,
measles/mumps/rubella (MMR) vaccine, pneumococcal vaccine, (and
varicella vaccine, if asymptomatic and immunologic class 1) are provided

**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

Medical record

#### LEVEL OF DETERMINATION OF QUALITY

Individual Case

#### PRE-EXISTING INSTRUMENT USED

Unspecified

### 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

External comparison at a point in time\
External comparison of time trends\
Internal time comparison

### Evaluation of Measure Properties

#### EXTENT OF MEASURE TESTING

Review tools are pilot tested by peer review agent prior to full
implementation.

The sample size is constructed by a statistical consultant based on a
facility\'s caseload to ensure reliability. A statewide HIV Quality of
Care Advisory Committee reviews indicators to ensure validity.

#### EVIDENCE FOR RELIABILITY/VALIDITY TESTING

Hatton TE. (Quality of Care Program Manager, AIDS Institute - NYSDOH).
Personal communication. 2006 Mar 13. 1 p.

### Identifying Information

#### ORIGINAL TITLE

Routine vaccinations.

#### MEASURE COLLECTION

[New York State Department of Health AIDS Institute, HIV Quality of Care
Program
Indicators](http://www.qualitymeasures.ahrq.gov/Browse/DisplayOrganization.aspx?org_id=1781&doc=7523)

#### MEASURE SET NAME

[Pediatric
Indicators](http://www.qualitymeasures.ahrq.gov/Browse/DisplayOrganization.aspx?org_id=1781&doc=8358)

#### DEVELOPER

New York State Department of Health AIDS Institute

#### FUNDING SOURCE(S)

A combination of the United States (U.S.) Government and New York State
funds.

#### COMPOSITION OF THE GROUP THAT DEVELOPED THE MEASURE

AIDS Institute staff, clinical experts from New York State

#### FINANCIAL DISCLOSURES/OTHER POTENTIAL CONFLICTS OF INTEREST

None

#### ADAPTATION

Measure was not adapted from another source.

#### RELEASE DATE

2000 Jul

#### REVISION DATE

2004 Jun

#### MEASURE STATUS

This is the current release of the measure.

#### SOURCE(S)

New York State Department of Health AIDS Institute HIV Quality of Care
Program. Pediatric indicators. \[internet\]. New York: New York State
Department of Health AIDS Institute; 2000-2004 \[cited 2005 Aug 10\].
\[2 p\]. Available: http://www.hivguidelines.org/Content.aspx?PageID=37.

#### MEASURE AVAILABILITY

The individual measure, \"Routine Vaccinations,\" is available in
Portable Document Format (PDF) from the [New York State Department of
Health AIDS Institute Web
site](http://www.hivguidelines.org/Content.aspx?PageID=37).

#### COMPANION DOCUMENTS

The following are available:

-   New York State Department of Health AIDS Institute. The HIV Quality
    of Care Program. New York (NY): New York State Department of Health
    AIDS Institute; 2004 Jun 1. 33 p. This document is available in
    Portable Document Format (PDF) from the [New York State Department
    of Health AIDS Institute Web
    site](http://www.hivguidelines.org/Content.aspx?PageID=29).

-   A consumer\'s guide to quality in HIV care in New York State. New
    York: New York State Department of Health AIDS Institute; 2003
    Sep 1. 11 p. This document is available in PDF from the [New York
    State Department of Health AIDS Institute Web
    site](http://www.hivguidelines.org/Content.aspx?pageID=461).

-   New York State Department of Health AIDS Institute. Clinical
    management of HIV infection. Quality of care performance in New York
    State 1999-2001. New York: New York Department of Health AIDS
    Institute; 2003 Sep 1. 62 p. This document is available in PDF from
    the [New York State Department of Health AIDS Institute Web
    site](http://www.hivguidelines.org/Content.aspx?PageID=9).

#### NQMC STATUS

This NQMC summary was completed by ECRI on November 15, 2005. The
information was verified by the measure developer on March 13, 2006.

#### COPYRIGHT STATEMENT

No copyright restrictions apply.

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© 2008 National Quality Measures Clearinghouse

Date Modified: 11/3/2008