AHRQ Tools and Resources for Better Health Care (continued)

AHRQ Quality Measurement Tools

Child Health Toolbox Helps Measure Quality

Because children's health care needs are different from those of adults, AHRQ has collected various measurement sets to assess the performance of child health programs and has made them accessible in its Child Health Toolbox. This online resource can help State and local policymakers, program directors, and staff develop plans that reliably measure the performance of child health programs, such as whether children are receiving quality health care and whether a health program is functioning effectively. Specifically, this Web site has access to tools and information on how to measure performance, access, quality, and health service delivery, as well as concepts, tips, and tools for evaluating Medicaid, the State Children's Health Insurance Program (SCHIP), Title V, and other health care service programs for children. Information about how to develop performance guidelines can also be found at this site.¹⁴

NQMC Will Expand Access to Quality Measures

AHRQ is sponsoring the development of the Internet-based National Quality Measures Clearinghouse™ (NQMC) to promote widespread access to quality measures. This resource of health quality measures significantly enhances, updates, and essentially replaces AHRQ's COmputerized Needs-oriented QUality Measurement Evaluation SysTem (CONQUEST), an earlier database of performance measures. The NQMC will use the Internet to effectively and efficiently reach a broad audience within the health care community. The database will help practitioners and organizations quickly identify and access quality measures. Summaries of quality measures will be retrievable by many parameters, including topic, target population, and setting of care. NQMC users will be able to search the NQMC and the NGC simultaneously.²⁸

AHRQ Quality Indicators Will Improve Hospital Care

AHRQ is developing three sets of Quality Indicators (QIs) to identify specific areas where problems may exist in a hospital: prevention, inpatient care, and patient safety. These indicators use hospital inpatient administrative data to measure health care quality. Program managers, researchers, and other health care decisionmakers can use the AHRQ QI software and user's guide to help them apply the QIs to their own data. The QIs can identify areas that need further study and investigation and can track changes over time.¹⁵

The Prevention QIs are a set of measures that can identify ambulatory-care-sensitive conditions. These are conditions for which good outpatient care might prevent the need for hospitalization or for which early intervention can prevent complications or more severe disease. Such conditions include bacterial pneumonia, urinary tract infections, congestive heart failure, and asthma.¹⁶

Inpatient QIs reflect the quality of care inside hospitals and include:

• Inpatient mortality for 13 medical conditions.
• Inpatient mortality for 9 procedures.
• Utilization rates of procedures for which there are questions of overuse, underuse, or misuse.
• Volume of procedures for which there is evidence that a higher volume of procedures is associated with lower mortality.¹⁵

The Inpatient QI software contains information at the hospital and area levels. Hospitals can use these data to identify questionable use of procedures to investigate quality problems and make improvements.²⁹

Patient Safety QIs also reflect quality of care inside hospitals but focus on surgical complications, adverse events, infections acquired in the hospital, and other problems that may result from medical treatment. This module is currently under development by the University of California at San Francisco-Stanford Evidence-based Practice Center. ¹⁵

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Conclusion

AHRQ has supported the development of a wide variety of tools and resources to provide accurate, timely, and relevant information on the status of health services. Federal and State agencies, legislators, clinicians, health plan administrators, employers, and universities use these tools and resources to make decisions, inform the public, educate health care professionals, and identify areas where health care services can be improved. By providing these tools, AHRQ has helped enhance the quality of health care and contributed to efforts to improve patient safety.

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For More Information

For further information on AHRQ tools and resources, contact:

• MEPS, Center for Cost and Financing Studies
  E-mail: mepspd@ahrq.gov
• HCUP, Center for Organization and Delivery Studies
  866-290-HCUP (4287)
  E-mail: hcup@ahrq.gov
• HIVnet, John Fleishman, Ph.D.
  (301) 427-1674
  E-mail: John.Fleishman@ahrq.hhs.gov
• CAHPS®, Christine Crofton, Ph.D.
  (301) 427-1323, or
  E-mail: cahps@ahrq.gov
• PPIP, Barbara Najar
  (301) 427-1399
  E-mail: Barbara.Najar@ahrq.hhs.gov
• NGC, Jean R. Slutsky, P.A., M.S.P.H.
  (301) 427-1600
  E-mail: info@guideline.gov
• Child Health Toolbox, Denise M. Dougherty, Ph.D.
  (301) 427-1868
  E-mail: Denise.Dougherty@ahrq.hhs.gov
• Quality Indicators
  E-mail: support@qualityindicators.ahrq.gov

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References

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*2. Eisenberg JM, Power EJ. Transforming insurance coverage into quality health care. JAMA 2000; 284(16):2100-7.

*3. Agency for Healthcare Research and Quality. Overview of the Medical Expenditure Panel Survey. AHRQ Web site: http://meps.ahrq.gov/whatismeps/overview.htm. Accessed May 17, 2002.

*4. Agency for Healthcare Research and Quality. MEPSnet. AHRQ Web site: http://meps.ahrq.gov/mepsnet/mepsnetintro.htm. Accessed May 17, 2002.

*5. Agency for Healthcare Research and Quality. HCUP: Multi-State administrative data system and software tools. Fact Sheet. Rockville (MD); Jan 2000. AHRQ Pub. No. 00-P021.

*6. Agency for Healthcare Research and Quality. Welcome to HCUPnet. AHRQ Web site: https://www.ahrq.gov/data/hcup/qifact.htm. Accessed May 17, 2002.

*7. Agency for Healthcare Research and Quality. Clinical Classifications Software. Fact Sheet. Rockville (MD); Jan 2000. AHRQ Pub. No. 00-P019. Also available on AHRQ Web site: https://www.ahrq.gov/data/hcup/ccsfact.htm. Accessed Sept 30, 2002.

*8. Agency for Healthcare Research and Quality. Clinical Classifications Software (ICD-10) summary and download. AHRQ Web site: http://www.hcup-us.ahrq.gov/toolssoftware/icd_10/ccs_icd_10.jsp. Accessed Sept 30, 2002.

*9. Agency for Healthcare Research and Quality. Welcome to HIVnet. AHRQ Web site: https://www.ahrq.gov/data/hivnet.htm. No longer active.

*10. Agency for Healthcare Research and Quality. Consumer Assessment of Health Plans (CAHPS®). Fact Sheet. Rockville, MD; April 2000. AHRQ Pub. No. 00-P047. Also available on AHRQ Web site: https://cahps.ahrq.gov. Accessed May 17, 2002.

*11. Agency for Healthcare Research and Quality. Understanding needs for health system preparedness and capacity for bioterrorist attacks. AHRQ Web site: https://www.ahrq.gov/about/cpcr/bioterrorism.htm. Accessed Sept 25, 2002.

*12. Agency for Healthcare Research and Quality. About PPIP. AHRQ Web site: https://www.ahrq.gov/ppip/ppipabou.htm. Accessed Sept 11, 2002.

*13. The National Guideline Clearinghouse™ (NGC). Accessed May 17, 2002.

*14. Agency for Healthcare Research and Quality. Child Health Toolbox. AHRQ Web site: https://www.ahrq.gov/chtoolbx/. Accessed May 17, 2002.

*15. Agency for Healthcare Research and Quality. AHRQ Quality Indicators. AHRQ Web site: https://www.ahrq.gov/data/hcup/qinext.htm. Accessed May 17, 2002.

*16. Agency for Healthcare Research and Quality. Prevention Quality Indicators, Version 2.1. AHRQ Web site: http://www.qualityindicators.ahrq.gov/data/hcup/prevqi.htm. Accessed May 17, 2002.

*17. Rhoades J. Statistical Brief #4. The uninsured in America-2001. Rockville (MD): Agency for Healthcare Research and Quality; 2002. AHRQ Web site: http://meps.ahrq.gov/mepsweb/data_files/publications/st4/stat04.pdf. Accessed Sept 25, 2002.

*18. Agency for Healthcare Research and Quality. Table 1. Total health services-median and mean expenses per person with expense and distribution of expenses by source of payment: United States, 1998. AHRQ Web site: http://meps.ahrq.gov/compendiumtables/98ch1/compendiumtables.htm. Accessed Oct 7, 2002.

*19. Agency for Healthcare Research and Quality. 2000 Medical Expenditure Panel Survey-Insurance Component. Table II.A.2(2000) Percent of private-sector establishments that offer health insurance by firm size and State: United States, 2000. AHRQ Web site: http://meps.ahrq.gov/mepsdata/ic/2000/index200.htm. Accessed Sept 25, 2002.

20. Institute of Medicine. Crossing the quality chasm: a new health system for the 21st Century. National Academy Press. Washington (DC); 2001. Web site: http://www.nap.edu/books/0309072808/html/. Accessed Sept 30, 2002.

*21. Agency for Healthcare Research and Quality. AHRQ data show rising hospital charges, falling hospital stays [press release]. Sept 18, 2002. AHRQ Web site: https://www.ahrq.gov/news/press/pr2002/rishospr.htm. Accessed Sept 25, 2002.

22. National Committee for Quality Assurance. The Health Plan Employer Data and Information Set (HEDIS®). NCQA Web site: http://www.ncqa.org/programs/hedis/index.htm. Accessed June 10, 2002.

*23. Agency for Healthcare Research and Quality. Partners in Prevention. Rockville (MD); March 2001. AHRQ Pub. No. APPIP 01-0008. Also available on AHRQ Web site: https://www.ahrq.gov/clinic/prev/partners.htm. Accessed Sept 11, 2002.

*24. Agency for Healthcare Research and Quality. 10 steps: implementation guide. Rockville, (MD); 1998. AHRQ Pub. No. APPIP 98-0025. Also available on AHRQ Web site: https://www.ahrq.gov/ppip/impsteps.htm. Accessed Sept 11, 2002.

*25. Agency for Healthcare Research and Quality. PPIP in practice: case studies. AHRQ Web site: https://www.ahrq.gov/ppip/ppipcase.htm. Accessed Sept 11, 2002.

*26. National Guideline Clearinghouse™. Inclusion criteria. Accessed June 3, 2002.

27. Institute of Medicine. Clinical practice guidelines: directions for a new program. Field MJ, Lohr KN (eds). Washington (DC): National Academy Press, 1990, page 38.

*28. Agency for Healthcare Research and Quality. Electronic Newsletter. 2001 Oct 26; 36. AHRQ Web site: https://www.ahrq.gov/news/enews/enews36.htm. Accessed June 19, 2002.

*29. Agency for Healthcare Research and Quality. Hospitals get new software tool to improve clinical care [press release]. July 18, 2002. AHRQ Web site: https://www.ahrq.gov/news/press/pr2002/inptqipr.htm. Accessed July 24, 2002.

*AHRQ-funded/sponsored research

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AHRQ Publication No. 03-0008
Released December 2002