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  • Measure Summary
  • NQMC:010889
  • Nov 2009

HIV oral health services: percentage of HIV-infected oral health patients who had a dental treatment plan developed and/or updated at least once in the measurement year.

Health Resources and Services Administration (HRSA). HAB HIV performance measures: oral health services. Rockville (MD): Health Resources and Services Administration (HRSA); 2009 Nov 23. 10 p.

View the original measure documentation External Web Site Policy

This is the current release of the measure.

Primary Measure Domain

Clinical Quality Measures: Process

Secondary Measure Domain

Does not apply to this measure

Description

This measure is used to assess the percentage of human immunodeficiency virus (HIV)-infected oral health patients who had a dental treatment plan developed and/or updated at least once in the measurement year.

Rationale

Human immunodeficiency virus (HIV)-related morbidity and mortality has dropped dramatically due to advances in HIV/acquired immune deficiency syndrome (AIDS) treatment. But reductions are uneven across HIV-infected populations due to unequal access to care and variable quality of services provided. Quality management seeks to enhance the quality of HIV care provided and increase access to services. They do so by measuring how health and social services meet established professional standards and user expectations.

A comprehensive dental treatment plan that includes preventive care, maintenance and elimination of oral pathology should be developed and discussed with the patient. Various treatment options should be discussed and developed in collaboration with the patient. As with all patients, a treatment plan appropriate for the patient's health status, financial status, and individual preference should be chosen.

Medications may interfere with dental treatment and cause adverse effects, such as decreased salivary flow, altered liver function, and bone marrow suppression, resulting in anemia, thrombocytopenia, and neutropenia. There is no evidence to support modifications in oral health care based solely on the presence of HIV infection. However, such modifications may be indicated on the basis of certain medical problems that occur as a result of HIV infection. Severely or terminally ill patients, for example, will require alterations in care similar to those of patients suffering from other conditions that cause debilitating illness, such as cancer or mental health impairment (Glick et al., 1994; "Dental management," 1995).

The American Dental Association (ADA) (2009) dental practice parameters address the process of diagnosis and treatment planning: "In the process of diagnosis and treatment planning, the attending dentist should review the accuracy of the data collected as part of patient evaluation. The behavioral, psychological, anatomical, developmental and physiological limitations of the patient should be considered by the dentist in performing the periodic evaluation and in developing the treatment plan."

Evidence for Rationale

American Dental Association (ADA). Dental practice parameters. Evaluation: patients requiring a comprehensive oral evaluation. [internet]. American Dental Association (ADA): Chicago (IL); 1995 [accessed 2009 May 08].

Dental management of the HIV-infected patient. J Am Dent Assoc. 1995 Dec;Suppl:1-40. PubMed External Web Site Policy

Glick M, Abel SN, Muzyka BC, DeLorenzo M. Dental complications after treating patients with AIDS. J Am Dent Assoc. 1994 Mar;125(3):296-301. PubMed External Web Site Policy

Health Resources and Services Administration (HRSA). Deliver HIV/AIDS care: quality of care. [internet]. Rockville (MD): Health Resources and Services Administration (HRSA); [accessed 2016 Jun 23].

Health Resources and Services Administration (HRSA). HAB HIV performance measures: oral health services. Rockville (MD): Health Resources and Services Administration (HRSA); 2009 Nov 23. 10 p.

Primary Health Components

Human immunodeficiency virus (HIV); oral health; dental treatment plan; oral evaluation

Denominator Description

Number of human immunodeficiency virus (HIV)-infected oral health patients that received a clinical oral evaluation at least once in the measurement year (see the related "Denominator Inclusions/Exclusions" field)

Numerator Description

Number of human immunodeficiency virus (HIV)-infected oral health patients who had a dental treatment plan developed and/or updated at least once in the measurement year (see the related "Numerator Inclusions/Exclusions" field)

Type of Evidence Supporting the Criterion of Quality for the Measure

  • A clinical practice guideline or other peer-reviewed synthesis of the clinical research evidence
  • One or more research studies published in a National Library of Medicine (NLM) indexed, peer-reviewed journal

Additional Information Supporting Need for the Measure

Unspecified

Extent of Measure Testing

Unspecified

State of Use

Current routine use

Current Use

Internal quality improvement

Measurement Setting

Ambulatory/Office-based Care

Professionals Involved in Delivery of Health Services

Dentists

Least Aggregated Level of Services Delivery Addressed

Individual Clinicians or Public Health Professionals

Statement of Acceptable Minimum Sample Size

Unspecified

Target Population Age

Age greater than or equal to 12 months

Target Population Gender

Either male or female

National Quality Strategy Aim

Better Care

National Quality Strategy Priority

Prevention and Treatment of Leading Causes of Mortality

IOM Care Need

Living with Illness

IOM Domain

Effectiveness

Case Finding Period

The measurement year

Denominator Sampling Frame

Patients associated with provider

Denominator (Index) Event or Characteristic

Clinical Condition

Diagnostic Evaluation

Patient/Individual (Consumer) Characteristic

Denominator Time Window

Does not apply to this measure

Denominator Inclusions/Exclusions

Inclusions
Number of human immunodeficiency virus (HIV)-infected oral health patients that received a clinical oral evaluation at least once in the measurement year

Note:

  • Clinical oral evaluations include evaluation, diagnosis and treatment planning. Refer to the original measure documentation for pertinent American Dental Association (ADA) Current Dental Terminology (CDT) codes.
  • Refer to the original measure documentation for additional data elements.

Exclusions

  • Patients who had only an evaluation or treatment for a dental emergency in the measurement year.
  • Patients who were less than 12 months old.

Note: Refer to the original measure documentation for ADA CDT codes for patient exclusions.

Exclusions/Exceptions

Unspecified

Numerator Inclusions/Exclusions

Inclusions
Number of human immunodeficiency virus (HIV)-infected oral health patients who had a dental treatment plan developed and/or updated at least once in the measurement year

Note: A complete dental treatment plan should include the following: provision for the relief of pain, elimination of infection; preventive plan component; periodontal treatment plan if necessary; elimination of caries; replacement or maintenance of tooth space or function; consultation or referral for conditions where treatment is beyond the scope of services offered; and determination of adequate recall interval.

Exclusions
Unspecified

Numerator Search Strategy

Fixed time period or point in time

Data Source

Administrative clinical data

Electronic health/medical record

National public health data

Paper medical record

Type of Health State

Does not apply to this measure

Instruments Used and/or Associated with the Measure

Unspecified

Measure Specifies Disaggregation

Does not apply to this measure

Scoring

Rate/Proportion

Interpretation of Score

Desired value is a higher score

Allowance for Patient or Population Factors

Unspecified

Standard of Comparison

Internal time comparison

Original Title

Oral health services: dental treatment plan.

Measure Collection Name

HIV/AIDS Bureau (HAB) Performance Measures

Measure Set Name

Oral Health Services

Submitter

Health Resources and Services Administration - Federal Government Agency [U.S.]

Developer

Health Resources and Services Administration - Federal Government Agency [U.S.]

Funding Source(s)

Unspecified

Composition of the Group that Developed the Measure

Unspecified

Financial Disclosures/Other Potential Conflicts of Interest

Unspecified

Adaptation

This measure was not adapted from another source.

Date of Most Current Version in NQMC

2009 Nov

Measure Maintenance

Unspecified

Date of Next Anticipated Revision

Unspecified

Measure Status

This is the current release of the measure.

Source(s)

Health Resources and Services Administration (HRSA). HAB HIV performance measures: oral health services. Rockville (MD): Health Resources and Services Administration (HRSA); 2009 Nov 23. 10 p.

Measure Availability

Source available from the Health Resources and Services Administration (HRSA) Web site External Web Site Policy.

For more information, contact the HRSA HIV/AIDS Bureau (HAB) at 5600 Fishers Lane, Rockville, MD 20857; E-mail: HIVmeasures@hrsa.gov; Web site: www.hrsa.gov/index.html External Web Site Policy.

NQMC Status

This NQMC summary was completed by ECRI Institute on July 8, 2016.

Copyright Statement

No copyright restrictions apply.

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