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## Complete Summary

#### TITLE

Preventive services: percentage of enrolled members ages less than or
equal to 18 years who are up-to-date for all appropriate preventive
services.

#### SOURCE(S)

HealthPartners. 2007 clinical indicators report: 2006/2007 results.
Minneapolis (MN): HealthPartners; 2007 Oct. 97 p.

### 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 enrolled members ages
less than or equal to 18 years who are up-to-date for all appropriate
preventive services based on age and gender.

#### RATIONALE

Appropriate and timely preventive care significantly reduces morbidity
and mortality. Preventive service rates improve if every patient
encounter is seen as an opportunity to address preventive care needs.
Looking at the member´s up-to-date status as inclusive of all required
preventive services, rather than individual, discrete services is more
meaningful and patient centered.

#### PRIMARY CLINICAL COMPONENT

Child and adolescent preventive services (hemoglobin, hematocrit, blood
pressure, lead screening, vision screening, height and weight, chlamydia
screening, tetanus, measles mumps rubella \[MMR\] booster, Hepatitis B,
immunization, childhood immunization combinations \[4 DTaP, 3 Polio, 1
MMR, 3 HiB, 1 VZV\] and \[DTaP #5, MMR #2, Polio #4\])

#### DENOMINATOR DESCRIPTION

Enrolled members ages less than or equal to 18 years by December 31 of
the measurement year who were continuously enrolled for one year as of
December 31, with not more than a 45 day break in coverage (see the
\"Description of Case Finding\" and \"Denominator
Inclusions/Exclusions\" fields in the Complete Summary)

#### NUMERATOR DESCRIPTION

Patients must be included in the denominator and have had appropriate
preventive services based on age and gender (see the related \"Numerator
Inclusions/Exclusions\" field in the Complete Summary)

### Evidence Supporting the Measure

#### EVIDENCE SUPPORTING THE CRITERION OF QUALITY

-   A clinical practice guideline or other peer-reviewed synthesis of
    the clinical evidence

### Evidence Supporting Need for the Measure

#### NEED FOR THE MEASURE

Use of this measure to improve performance\
Variation in quality for the performance measured

#### EVIDENCE SUPPORTING NEED FOR THE MEASURE

HealthPartners. 2007 clinical indicators report: 2006/2007 results.
Minneapolis (MN): HealthPartners; 2007 Oct. 97 p.

### State of Use of the Measure

#### STATE OF USE

Current routine use

#### CURRENT USE

Internal quality improvement\
National reporting\
Pay-for-performance

### Application of Measure in its Current Use

#### CARE SETTING

Physician Group Practices/Clinics

#### PROFESSIONALS RESPONSIBLE FOR HEALTH CARE

Advanced Practice Nurses\
Physician Assistants\
Physicians

#### LOWEST LEVEL OF HEALTH CARE DELIVERY ADDRESSED

Group Clinical Practices

#### TARGET POPULATION AGE

Ages less than or equal to 18 years

#### TARGET POPULATION GENDER

Either male or female

#### STRATIFICATION BY VULNERABLE POPULATIONS

Unspecified

### Characteristics of the Primary Clinical Component

#### INCIDENCE/PREVALENCE

Unspecified

#### ASSOCIATION WITH VULNERABLE POPULATIONS

Unspecified

#### BURDEN OF ILLNESS

Unspecified

#### UTILIZATION

Unspecified

#### COSTS

Unspecified

### Institute of Medicine National Healthcare Quality Report Categories

#### IOM CARE NEED

Staying Healthy

#### IOM DOMAIN

Effectiveness

### Data Collection for the Measure

#### CASE FINDING

Users of care only

#### DESCRIPTION OF CASE FINDING

Enrolled members ages less than or equal to 18 years as of December 31
of the measurement year who were continuously enrolled within the health
plan for one year as of December 31, with not more than a 45 day break
in coverage

#### DENOMINATOR SAMPLING FRAME

Patients associated with provider

#### DENOMINATOR INCLUSIONS/EXCLUSIONS

**Inclusions**\
Enrolled members ages less than or equal to 18 years by December 31 of
the measurement year who were continuously enrolled for one year as of
December 31, with not more than a 45 day break in coverage

**Exclusions**

-   Members can be validly excluded from the measure if they died in
    measurement year or sampling error (incorrect age).

-   Members can be validly excluded from a component if there is a
    contraindication.

#### RELATIONSHIP OF DENOMINATOR TO NUMERATOR

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

#### DENOMINATOR (INDEX) EVENT 

Encounter

#### DENOMINATOR TIME WINDOW

Time window precedes index event

#### NUMERATOR INCLUSIONS/EXCLUSIONS

**Inclusions**\
Patients must be included in the denominator and have had appropriate
preventive services\* based on age and gender

\**Preventive services timeframes and ages audited for each component*
include:

-   Blood pressure (last 3 years) (ages greater than or equal to 5 and
    less than or equal to 18)

-   Lead screening (once by age 2) (age 2)

-   Vision screening (once by age 5) (age 5)

-   Height and weight (recorded on same date in recording year) (ages
    greater than or equal to 3 and less than or equal to 18 \[age 2 +
    one year for annual\])

-   Chlamydia screening (in measurement year) (sexually active women per
    HEDIS specs, age greater than or equal to 16 and less than or equal
    to 18)

-   Tetanus, adolescent (less than or equal to 13 years) (age 13)

-   Measles mumps rubella (MMR) booster (less than or equal to 13 years)
    (age 13)

-   Hepatitis B (series of 3, less than or equal to 13 years) 9age 130

-   Immunization combination ages 2 to 4 (up-to-date December 31 of
    measurement year)(4 diphtheria, tetanus, acellular pertussis
    \[DTaP\], 3 Polio, 1 MMR, 3 Haemophilus influenza type B \[HiB\], 1
    varicella \[VZV\])

-   Immunization combination ages 7 and 8 (up-to-date less than or equal
    to 7 years) (DTaP booster, MMR #2, Polio #4)

**Exclusions**\
Unspecified

#### 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

Encounter or point in time

#### DATA SOURCE

Administrative data\
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\
Prescriptive standard

#### PRESCRIPTIVE STANDARD

Percent reaching all targets - 2007 Goal:

-   Excellent\--90%

-   Superior\--95%

#### EVIDENCE FOR PRESCRIPTIVE STANDARD

HealthPartners. 2007 clinical indicators report: 2006/2007 results.
Minneapolis (MN): HealthPartners; 2007 Oct. 97 p.

### Evaluation of Measure Properties

#### EXTENT OF MEASURE TESTING

This measure has been used to report medical group and health plan
performance for four years. Data accuracy has been verified by medical
group and health plan personnel over that period.

#### EVIDENCE FOR RELIABILITY/VALIDITY TESTING

Institute for Clinical Systems Improvement (ICSI). Preventive services
for children and adolescents. Bloomington (MN): Institute for Clinical
Systems Improvement (ICSI); 2006 Oct. 77 p. \[153 references\]

### Identifying Information

#### ORIGINAL TITLE

Preventive services, child and adolescent.

#### MEASURE COLLECTION

[HealthPartners Clinical
Indicators](http://www.qualitymeasures.ahrq.gov/Browse/DisplayOrganization.aspx?org_id=1376&doc=4306)

#### MEASURE SET NAME

[Preventive Services (Health Partners Clinical
Indicators)](http://www.qualitymeasures.ahrq.gov/Browse/DisplayOrganization.aspx?org_id=1376&doc=12279)

#### DEVELOPER

HealthPartners

#### ADAPTATION

Measure was not adapted from another source.

#### RELEASE DATE

2004 Oct

#### REVISION DATE

2007 Oct

#### MEASURE STATUS

This is the current release of the measure.

#### SOURCE(S)

HealthPartners. 2007 clinical indicators report: 2006/2007 results.
Minneapolis (MN): HealthPartners; 2007 Oct. 97 p.

#### MEASURE AVAILABILITY

The individual measure, \"Preventive Services, Child and Adolescent,\"
is published in the \"2007 Clinical Indicators Report: 2006/2007
Results.\"

For print copies of the 2007 Clinical Indicators Report: 2006/2007
Results, please contact HealthPartners Quality Measurement and
Improvement Department at (952) 883-5777; E-mail:
<quality@healthpartners.com>; Web site:
[www.healthpartners.com](http://www.healthpartners.com/).

#### COMPANION DOCUMENTS

The following is available:

-   Institute for Clinical Systems Improvement (ICSI). Preventive
    services for children and adolescents. Bloomington (MN): Institute
    for Clinical Systems Improvement (ICSI); 2006 Oct. 77 p.

#### NQMC STATUS

This NQMC summary was completed by ECRI Institute on May 23, 2008. The
information was verified by the measure developer on June 20, 2008.

#### COPYRIGHT STATEMENT

This NQMC summary is based on the original measure, which is subject to
the measure developer\'s copyright restrictions.

### Disclaimer

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© 2008 National Quality Measures Clearinghouse

Date Modified: 11/3/2008