HAB HIV Core Clinical Performance Measures for 

Adult/Adolescent Clients: Group 3

Final: April 2009  Page 17 

Performance Measure: Substance Use 

Screening

OPR-Related Measure: Yes 

www.hrsa.gov/performancereview/measures.htm 

Percentage of new clients1 with HIV infection who have been screened2 for substance use 

(alcohol & drugs) in the measurement year 

Numerator: Number of new HIV-infected clients who were screened for substance use 

within the measurement year 

Denominator: 

Number of HIV-infected clients who: 

 were new during the measurement year, and 

 had a medical visit with a medical provider with prescribing privileges3 at 

least once in the measurement year 

Patient 

Exclusions: None 

Data 

Elements: 

1. Is the client HIV-infected? (Y/N) 

a. If yes, was the client new to the program during the 

reporting period? (Y/N) 

i. If yes, was the client screened for substance use 

during the measurement year? (Y/N) 

Data Sources: 

 Electronic Medical Record/Electronic Health Record 

 CAREWare, Lab Tracker, or other electronic data base 

 HIVQUAL reports on this measure for grantee under review 

 Medical record data abstraction by grantee of a sample of records 

 Billing records 

National 

Goals, 

Targets, or 

Benchmarks 

for 

Comparison 

IHI Goal: 90%4 

National HIVQUAL Performance Data:5 

 2003 2004 2005 2006 2007

Top 10% 100% 100% 100% 100% 100% 

Top 25% 92.3% 100% 100% 100% 100% 

Mean* 73.4% 76.5% 78.9% 81.4% 80.6% 

*from HAB data base 

Outcome 

Measures for 

Consideration: 

 Substance use-related mortality rates 

 Rate of substance use-related hospitalizations 

 Rate of substance use referrals 

Basis for Selection and Placement in Group 3: 

Patients living with HIV infection must often cope with multiple social, psychiatric, and medical 

issues. 
HAB HIV Core Clinical Performance Measures for 

Adult/Adolescent Clients: Group 3

Final: April 2009  Page 18 

The measure was placed in Group 3 because the feasibility of data collection can vary 

considerably across grantees. 

US Public Health Guidelines: 

“Patients living with HIV infection must often cope with multiple social, psychiatric, and medical 

issues. Thus, the (initial) evaluation should also include assessment of substance abuse, 

economic factors, social support, mental illness, co-morbidities, and other factors that are known 

to impair the ability to adhere to treatment and to alter outcomes. Once evaluated, these factors 

should be managed accordingly."6

 

References/Notes: 

1

 “Clients” includes all clients aged 13 years and older. 

2

 The purpose of screening is to identify past or current substance use that negatively impacts 

linkage to care and health care in general. A substance use screen includes documentation of past 

and current substance use and treatment in the HIV primary care record. Screening can be 

provided by any member of the multidisciplinary primary care team. 

3

A “provider with prescribing privileges” is a health care professional who is certified in their 

jurisdiction to prescribe medications. 

4 IHI Measure reads, “Percent of Patients/Clients Assessed for Substance Use and/or Tobacco Use 

in the Past 12 Months” 

(http://www.ihi.org/IHI/Topics/HIVAIDS/HIVDiseaseGeneral/Measures/PercentofPatientsClient

sAssessedforSubstanceUseandorTobaccoUseinthePast12Months.htm) 

5

Substance Use Screening 

(http://www.hivguidelines.org/admin/files/qoc/hivqual/proj%20info/HQNatlAggScrs3Yrs.pdf) 

6

Guidelines for the Use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents (p. 

13) (http://aidsinfo.nih.gov/ContentFiles/AdultandAdolescentGL.pdf)