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## Complete Summary

#### TITLE

Gastroenterology: percentage of patients admitted to hospital with
haematemesis and/or melaena, who receive a blood transfusion and
endoscopic therapy, who subsequently have an operation, during the 6
month time period.

#### SOURCE(S)

Australian Council on Healthcare Standards (ACHS). ACHS clinical
indicator users\' manual 2008. ULTIMO NSW: Australian Council on
Healthcare Standards (ACHS); 2007 Dec. 776 p.

### Measure Domain

#### PRIMARY MEASURE DOMAIN

Use of Services

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 patients admitted to
hospital with haematemesis and/or melaena, who receive a blood
transfusion and endoscopic therapy, who subsequently have an operation,
during the same admission, during the 6 month time period.

#### RATIONALE

Haematemesis and melaena (H&M) are common symptoms necessitating
admission to hospital and often indicate significant potential
morbidity.

#### PRIMARY CLINICAL COMPONENT

Haematemesis; melaena; blood transfusion; hospital admission; endoscopic
therapy; operation

#### DENOMINATOR DESCRIPTION

Total number of patients admitted to hospital with haematemesis and/or
melaena who receive a blood transfusion, during the 6 month time period
(see the related \"Denominator Inclusions/Exclusions\" field in the
Complete Summary)

#### NUMERATOR DESCRIPTION

Total number of patients admitted to hospital with haematemesis and/or
melaena, having both blood transfusion and endoscopic therapy\*, who
subsequently have an operation, during the same admission, during the 6
month time period

\*Endoscopic therapy refers to measures to control bleeding by the
application of heat, energy or an injection of pharmaceutical agents,
during endoscopy.

### Evidence Supporting the Measure

#### EVIDENCE SUPPORTING THE VALUE OF MONITORING USE OF SERVICE

-   A formal consensus procedure involving experts in relevant clinical,
    methodological, and organizational sciences

### Evidence Supporting Need for the Measure

#### NEED FOR THE MEASURE

Monitoring and planning

#### EVIDENCE SUPPORTING NEED FOR THE MEASURE

Australian Council on Healthcare Standards (ACHS). Australian clinical
indicator report 1998-2006. Determining the potential to improve quality
of care: 8th edition. ULTIMO NSW: Australian Council on Healthcare
Standards (ACHS); 2007. 564 p.

### State of Use of the Measure

#### STATE OF USE

Current routine use

#### CURRENT USE

Monitoring and planning

### Application of Measure in its Current Use

#### CARE SETTING

Hospitals

#### PROFESSIONALS RESPONSIBLE FOR HEALTH CARE

Physicians

#### LOWEST LEVEL OF HEALTH CARE DELIVERY ADDRESSED

Single Health Care Delivery Organizations

#### TARGET POPULATION AGE

Unspecified

#### 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

Not within an IOM Care Need

#### IOM DOMAIN

Not within an IOM Domain

### Data Collection for the Measure

#### CASE FINDING

Users of care only

#### DESCRIPTION OF CASE FINDING

Patients admitted to hospital with haematemesis and/or melaena who
receive a blood transfusion, during the 6 month time period

#### DENOMINATOR SAMPLING FRAME

Patients associated with provider

#### DENOMINATOR INCLUSIONS/EXCLUSIONS

**Inclusions**\
Total number of patients admitted to hospital with haematemesis and/or
melaena\* who receive a blood transfusion, during the 6 month time
period

\*International Classification of Diseases, Tenth Revision, Australian
Modification (ICD-10-AM) codes capture the principal and additional
diagnoses on discharge, i.e., the underlying cause of condition, rather
than its symptoms, will be coded. It is not possible to capture all
cases of haematemesis and/or melaena on admission via ICD-10-AM coding.

**Exclusions**\
Patients with oesophageal varices during this admission are excluded.

#### RELATIONSHIP OF DENOMINATOR TO NUMERATOR

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

#### DENOMINATOR (INDEX) EVENT 

Clinical Condition\
Institutionalization\
Therapeutic Intervention

#### DENOMINATOR TIME WINDOW

Time window brackets index event

#### NUMERATOR INCLUSIONS/EXCLUSIONS

**Inclusions**\
Total number of patients admitted to hospital with haematemesis and/or
melaena, having both blood transfusion and endoscopic therapy\*, who
subsequently have an operation, during the same admission, during the 6
month time period

\*Endoscopic therapy refers to measures to control bleeding by the
application of heat, energy or an injection of pharmaceutical agents,
during endoscopy.

**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

Institutionalization

#### DATA SOURCE

Administrative data\
Medical record

#### LEVEL OF DETERMINATION OF QUALITY

Does not apply to this measure

#### PRE-EXISTING INSTRUMENT USED

Unspecified

### Computation of the Measure

#### SCORING

Rate

#### INTERPRETATION OF SCORE

Undetermined

#### 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

Unspecified

### Identifying Information

#### ORIGINAL TITLE

Indicator area 3: gastroenterology CI 3.5.

#### MEASURE COLLECTION

[Australian Council on Healthcare Standards (ACHS) Equip Clinical
Indicators](http://www.qualitymeasures.ahrq.gov/Browse/DisplayOrganization.aspx?org_id=1984&doc=11061)

#### MEASURE SET NAME

[Internal Medicine
Indicators](http://www.qualitymeasures.ahrq.gov/Browse/DisplayOrganization.aspx?org_id=1984&doc=11517)

#### DEVELOPER

Australian Council on Healthcare Standards

#### FUNDING SOURCE(S)

Funding is direct Australian Council on Healthcare Standards (ACHS)
funding sourced through our membership. ACHS does not receive external
funding from the government or other sources.

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

Our terms of reference dictate the composition of the working parties
that develop our indicators and include the following:

-   Two Clinicians \-- nominated by the relevant specialty
    college/association/society, one nominated to be the chair of the
    working party

-   Private Hospital Representative \-- nominated by the Australian
    Private Hospital Association

-   Consumer Representative \-- nominated by the Consumer Health Forum
    of Australia

-   Coding Representative \-- nominated by the National Centre for
    Clinical classification on Health

-   Quality Health New Zealand, nominated by QHNZ (if applicable)

-   Epidemiological/Clinical Research Representative, Director of Health
    Services Research Group, University of Newcastle

-   Australian Council on Healthcare Standards (ACHS) Representatives
    \-- Clinical Director, Coordinator, Administrative Assistant

-   Other Expert Stakeholders, as required

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

None

#### ADAPTATION

Measure was not adapted from another source.

#### RELEASE DATE

1996 Sep

#### REVISION DATE

2007 Dec

#### MEASURE STATUS

This is the current release of the measure.

#### SOURCE(S)

Australian Council on Healthcare Standards (ACHS). ACHS clinical
indicator users\' manual 2008. ULTIMO NSW: Australian Council on
Healthcare Standards (ACHS); 2007 Dec. 776 p.

#### MEASURE AVAILABILITY

The individual measure, \"Indicator Area 3: Gastroenterology CI 3.5,\"
is published in \"ACHS Clinical Indicator Users\' Manual 2008.\"

For more information contact, the Australian Council on Healthcare
Standards (ACHS), 5 Macarthur Street, ULTIMO NSW 2007; Phone: (02) 9281
9955; Fax: (02) 9211 9633; E-mail: <pos@achs.org.au>; Web site:
[www.achs.org.au](http://www.achs.org.au/).

#### COMPANION DOCUMENTS

The following is available:

-   Australian Council on Healthcare Standards (ACHS). Australian
    clinical indicator report 1998-2006. Determining the potential to
    improve quality of care: 8th edition. ULTIMO NSW: Australian Council
    on Healthcare Standards (ACHS); 2007. 564 p. This document is
    available in Portable Document Format (PDF) from the [Australian
    Council on Healthcare Standards (ACHS) Web
    site](http://www.achs.org.au/pdf/Australasian_CIR_8th_Edition.pdf).

#### NQMC STATUS

This NQMC summary was completed by ECRI Institute on June 10, 2008.

#### COPYRIGHT STATEMENT

This NQMC summary is based on the original measure, which is subject to
the measure developer\'s copyright restrictions. This work is copyright.
Apart from any use as permitted under the Copyright Act 1968, no part
may be reproduced by any process without written permission from The
Australian Council on Healthcare Standards (ACHS).

### Disclaimer

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© 2008 National Quality Measures Clearinghouse

Date Modified: 11/10/2008