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  • Measure Summary
  • NQMC:010892
  • Nov 2009

HIV oral health services: percentage of HIV-infected oral health patients with a Phase 1 treatment plan that is completed within 12 months.

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 with a Phase 1 treatment plan that is completed within 12 months.

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.

Oral diseases are progressive and cumulative and can affect our ability to eat, the foods we choose, how we look, and the way we communicate. These diseases can affect economic productivity and compromise our ability to work at home, at school, or on the job. Health disparities exist across population groups at all ages. Over one third of the United States (U.S.) population (100 million people) has no access to community water fluoridation. Over 108 million children and adults lack dental insurance, which is over 2.5 times the numbers who lack medical insurance (U.S. Department of Health and Human Services [DHHS], 2000).

Community and migrant health center oral health programs seek to increase access to oral health care for the underserved. This performance measure addresses two fundamental areas within community and migrant health center oral health programs: 1) the need to perform a comprehensive oral health exam that culminates with an accompanying treatment plan and 2) assuring that quality care is incorporated in the process of completing needed treatment in a timely manner. The measure facilitates the identification of contributing and restricting factors and practical low cost improvement options relevant to significant areas listed above.

With access to codes associated with comprehensive oral exams and patient treatment completion (PTC), most management information systems will be able to provide an average length of time associated with completion of treatment. With this information, staffing patterns, financial costs (overhead expenses) and efficiency of the oral health program can be assessed. These additional benchmarks could also be measured across health center programs at the local, regional and national levels. The ultimate goal is to measure and assure that health centers routinely and systematically deliver comprehensive, quality oral health services and patient treatment is completed within a reasonable amount of time.

The performance measure is comprehensive in that subsequent performance analysis can broach a number of significant areas, such as: appointment scheduling, ratio of oral health providers to dental operatories, ratio of oral health providers to support staff, collaboration with medical colleagues emphasizing oral health as an essential component of an interdisciplinary approach to patient care, prioritization of patients and/or procedures, general productivity and efficiency.

Evidence for Rationale

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.

U.S. Department of Health and Human Services (DHHS). Oral health in America: a report of the Surgeon General - executive summary. Rockville (MD): U.S. Department of Health and Human Services (DHHS), National Institute of Dental and Craniofacial Research, National Institutes of Health; 2000. various p.

Primary Health Components

Human immunodeficiency virus (HIV); oral health; Phase 1 treatment plan

Denominator Description

Number of human immunodeficiency virus (HIV)-infected oral health patients with a Phase 1 treatment plan established in the year prior to the measurement year (see the related "Denominator Inclusions/Exclusions" field)

Numerator Description

Number of human immunodeficiency virus (HIV)-infected oral health patients that completed Phase 1 treatment within 12 months of establishing a treatment plan (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

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

Patient/Individual (Consumer) Characteristic

Therapeutic Intervention

Denominator Time Window

Does not apply to this measure

Denominator Inclusions/Exclusions

Inclusions
Number of human immunodeficiency virus (HIV)-infected oral health patients with a Phase 1 treatment plan established in the year prior to the measurement year

Note:

  • Patients initiating Phase 1 treatment plan would not be captured in the denominator in the current measurement year. They would, if the care was completed on schedule, be captured in the performance data in the following measurement year.
  • 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 year prior to the measurement year.

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 that completed Phase 1 treatment within 12 months of establishing a treatment plan

Note: Phase 1 Treatment: Prevention, maintenance and/or elimination of oral pathology that results from dental caries or periodontal disease. This includes: restorative treatment; basic periodontal therapy (non surgical); basic oral surgery that includes simple extractions and biopsy; non-surgical endodontic therapy; and space maintenance and tooth eruption guidance for transitional dentition.

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

Phase 1 treatment plan completion.

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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