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  • Measure Summary
  • NQMC:010557
  • Oct 2015

Management of urinary incontinence in older adults: the percentage of Medicare members 65 years of age and older who reported having urine leakage in the past six months and who discussed their urinary leakage problem with a health care provider.

National Committee for Quality Assurance (NCQA). HEDIS 2016: Healthcare Effectiveness Data and Information Set. Vol. 1, narrative. Washington (DC): National Committee for Quality Assurance (NCQA); 2015. various p.
National Committee for Quality Assurance (NCQA). HEDIS 2016: Healthcare Effectiveness Data and Information Set. Vol. 2, technical specifications for health plans. Washington (DC): National Committee for Quality Assurance (NCQA); 2015. various p.
National Committee for Quality Assurance (NCQA). HEDIS 2016: Healthcare Effectiveness Data and Information Set. Vol. 6, specifications for the Medicare health outcomes survey. Washington (DC): National Committee for Quality Assurance (NCQA); 2015. various p.

This is the current release of the measure.

This measure updates previous versions:

  • National Committee for Quality Assurance (NCQA). HEDIS 2015: Healthcare Effectiveness Data and Information Set. Vol. 1, narrative. Washington (DC): National Committee for Quality Assurance (NCQA); 2014. various p.
  • National Committee for Quality Assurance (NCQA). HEDIS 2015: Healthcare Effectiveness Data and Information Set. Vol. 2, technical specifications for health plans. Washington (DC): National Committee for Quality Assurance (NCQA); 2014. various p.
  • National Committee for Quality Assurance (NCQA). HEDIS 2015: Healthcare Effectiveness Data and Information Set. Vol. 6, specifications for the Medicare health outcomes survey. Washington (DC): National Committee for Quality Assurance (NCQA); 2015. various p.

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 Medicare members 65 years of age and older who reported having urine leakage in the past six months and who discussed their urinary leakage problem with a health care provider.

This is one component of a three-part survey measure that provides information on how well physicians manage urinary incontinence (UI) in Medicare members 65 and older. See the following related National Quality Measures Clearinghouse (NQMC) summaries of the National Committee for Quality Assurance (NCQA) measures:

This measure is collected using the Medicare Health Outcomes Survey (HOS). Results are calculated by NCQA using data collected in the combined baseline and follow-up survey samples from the same measurement year.

Rationale

Urinary incontinence (UI), or the unintentional loss of urine, is a condition that affects between 10 percent and 30 percent of adults. An estimated 13 million Americans suffer from bladder control problems; 85 percent of these are women. The prevalence of UI increases with age, and although it should not be considered a normal part of aging, up to 35 percent of people 60 years of age and older are incontinent. The underlying causes of UI can be diagnosed and managed effectively by a practitioner (Tannenbaum et al., 2001; Lee, Phanumus, & Fields, 2000). UI can cause a wide range of morbidity in the elderly, including pressure ulcers, urinary tract infections (UTIs), social withdrawal and depression ("Overview," 1996). UI is one of the major causes of institutionalization of the elderly (National Kidney and Urologic Disease Advisory Board, 1994; "Assessment," 2000).

Evidence for Rationale

Assessment and treatment of urinary incontinence. Scientific Committee of the First International Consultation on Incontinence. Lancet. 2000 Jun 17;355(9221):2153-8. [5 references] PubMed External Web Site Policy

Lee SY, Phanumus D, Fields SD. Urinary incontinence. A primary care guide to managing acute and chronic symptoms in older adults. Geriatrics. 2000 Nov;55(11):65-71; quiz 72. [20 references] PubMed External Web Site Policy

National Committee for Quality Assurance (NCQA). HEDIS 2016: Healthcare Effectiveness Data and Information Set. Vol. 1, narrative. Washington (DC): National Committee for Quality Assurance (NCQA); 2015. various p.

National Kidney and Urologic Disease Advisory Board. 1994.

Overview: urinary incontinence in adults, clinical practice guideline update. [internet]. Rockville (MD): Agency for Healthcare Research and Quality (AHRQ); 1996 Mar [4 p].

Tannenbaum C, Perrin L, DuBeau CE, Kuchel GA. Diagnosis and management of urinary incontinence in the older patient. Arch Phys Med Rehabil. 2001 Jan;82(1):134-8. [32 references] PubMed External Web Site Policy

Primary Health Components

Urinary incontinence (UI)

Denominator Description

Medicare members 65 years of age and older as of December 31 of the measurement year who reported having any urinary incontinence in the past six months (see the related "Denominator Inclusions/Exclusions" field)

Numerator Description

The number of members in the denominator who indicated they discussed their urinary incontinence with a health care provider (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
  • A formal consensus procedure, involving experts in relevant clinical, methodological, public health and organizational sciences
  • 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

All HEDIS measures undergo systematic assessment of face validity with review by measurement advisory panels, expert panels, a formal public comment process and approval by the National Committee for Quality Assurance's (NCQA's) Committee on Performance Measurement and Board of Directors. Where applicable, measures also are assessed for construct validity using the Pearson correlation test. All measures undergo formal reliability testing of the performance measure score using beta-binomial statistical analysis.

Evidence for Extent of Measure Testing

Rehm B. (Assistant Vice President, Performance Measurement, National Committee for Quality Assurance, Washington, DC). Personal communication. 2015 Mar 16.  1 p.

State of Use

Current routine use

Current Use

Accreditation

Decision-making by businesses about health plan purchasing

Decision-making by consumers about health plan/provider choice

External oversight/Medicare

Internal quality improvement

Public reporting

Measurement Setting

Managed Care Plans

Professionals Involved in Delivery of Health Services

Advanced Practice Nurses

Nurses

Physician Assistants

Physicians

Least Aggregated Level of Services Delivery Addressed

Single Health Care Delivery or Public Health Organizations

Statement of Acceptable Minimum Sample Size

Specified

Target Population Age

Age greater than or equal to 65 years

Target Population Gender

Either male or female

National Quality Strategy Aim

Better Care

National Quality Strategy Priority

Person- and Family-centered Care
Prevention and Treatment of Leading Causes of Mortality

IOM Care Need

Getting Better

Living with Illness

IOM Domain

Effectiveness

Patient-centeredness

Case Finding Period

The measurement year

Denominator Sampling Frame

Enrollees or beneficiaries

Denominator (Index) Event or Characteristic

Clinical Condition

Patient/Individual (Consumer) Characteristic

Denominator Time Window

Does not apply to this measure

Denominator Inclusions/Exclusions

Inclusions
Medicare members 65 years of age and older as of December 31 of the measurement year who reported having any urinary incontinence in the past six months

Member choices must be as follows to be included in the denominator:

  • Q42: Many people experience leaking of urine, also called urinary incontinence. In the past six months, have you experienced leaking of urine? = "Yes"
  • Q44: Have you ever talked with a doctor, nurse, or other health care provider about leaking of urine? = "Yes" or "No"

Exclusions
Members assigned one of the following disposition status codes are ineligible for the survey:

  • Deceased*
  • Not enrolled in the Medicare Advantage Organization (MAO)
  • Language barrier
  • Removed from sample
  • Duplicate, beneficiary listed twice in the sample frame
  • Bad address and nonworking/unlisted phone number, or member is unknown at the dialed phone number
  • Nonresponse:
    • Partial complete survey (between 50 percent and 79 percent completed or 80 percent or more completed with an Activities of Daily Living [ADL] item unanswered)
    • Break-off (less than 50 percent completed)
    • Refusal
    • Respondent unavailable
    • Respondent physically or mentally incapacitated
    • Respondent institutionalized
    • Nonresponse after maximum attempts

*Deceased members are excluded from follow-up samples but are included in the calculation of Health Outcomes Survey (HOS) results.

Exclusions/Exceptions

Patient factors addressed

Numerator Inclusions/Exclusions

Inclusions
The number of members in the denominator who indicated they discussed their urinary incontinence with a health care provider

Member choice must be as follows to be included in the numerator:

  • Q44: Have you ever talked with a doctor, nurse, or other health care provider about leaking of urine? = "Yes"

Exclusions
Unspecified

Numerator Search Strategy

Fixed time period or point in time

Data Source

Administrative clinical data

Patient/Individual survey

Type of Health State

Does not apply to this measure

Instruments Used and/or Associated with the Measure

Medicare Health Outcomes Survey (HOS)

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

External comparison at a point in, or interval of, time

External comparison of time trends

Internal time comparison

Original Title

Management of urinary incontinence in older adults (MUI): discussing urinary incontinence.

Measure Collection Name

HEDIS 2016: Health Plan Collection

Measure Set Name

Effectiveness of Care

Measure Subset Name

Measures Collected Through Medicare Health Outcomes Survey

Submitter

National Committee for Quality Assurance - Health Care Accreditation Organization

Developer

National Committee for Quality Assurance - Health Care Accreditation Organization

Funding Source(s)

Unspecified

Composition of the Group that Developed the Measure

National Committee for Quality Assurance's (NCQA's) Measurement Advisory Panels (MAPs) are composed of clinical and research experts with an understanding of quality performance measurement in the particular clinical content areas.

Financial Disclosures/Other Potential Conflicts of Interest

In order to fulfill National Committee for Quality Assurance's (NCQA's) mission and vision of improving health care quality through measurement, transparency and accountability, all participants in NCQA's expert panels are required to disclose potential conflicts of interest prior to their participation. The goal of this Conflict Policy is to ensure that decisions which impact development of NCQA's products and services are made as objectively as possible, without improper bias or influence.

Adaptation

This measure was not adapted from another source.

Date of Most Current Version in NQMC

2015 Oct

Measure Maintenance

Unspecified

Date of Next Anticipated Revision

Unspecified

Measure Status

This is the current release of the measure.

This measure updates previous versions:

  • National Committee for Quality Assurance (NCQA). HEDIS 2015: Healthcare Effectiveness Data and Information Set. Vol. 1, narrative. Washington (DC): National Committee for Quality Assurance (NCQA); 2014. various p.
  • National Committee for Quality Assurance (NCQA). HEDIS 2015: Healthcare Effectiveness Data and Information Set. Vol. 2, technical specifications for health plans. Washington (DC): National Committee for Quality Assurance (NCQA); 2014. various p.
  • National Committee for Quality Assurance (NCQA). HEDIS 2015: Healthcare Effectiveness Data and Information Set. Vol. 6, specifications for the Medicare health outcomes survey. Washington (DC): National Committee for Quality Assurance (NCQA); 2015. various p.

Source(s)

National Committee for Quality Assurance (NCQA). HEDIS 2016: Healthcare Effectiveness Data and Information Set. Vol. 1, narrative. Washington (DC): National Committee for Quality Assurance (NCQA); 2015. various p.

National Committee for Quality Assurance (NCQA). HEDIS 2016: Healthcare Effectiveness Data and Information Set. Vol. 2, technical specifications for health plans. Washington (DC): National Committee for Quality Assurance (NCQA); 2015. various p.

National Committee for Quality Assurance (NCQA). HEDIS 2016: Healthcare Effectiveness Data and Information Set. Vol. 6, specifications for the Medicare health outcomes survey. Washington (DC): National Committee for Quality Assurance (NCQA); 2015. various p.

Measure Availability

Source available for purchase from the National Committee for Quality Measurement (NCQA) Web site External Web Site Policy.

For more information, contact NCQA at 1100 13th Street, NW, Suite 1000, Washington, DC 20005; Phone: 202-955-3500; Fax: 202-955-3599; Web site: www.ncqa.org External Web Site Policy.

Companion Documents

The following is available:

  • National Committee for Quality Assurance (NCQA). HEDIS 2016: Healthcare Effectiveness Data and Information Set. Vol. 2, technical update. Washington (DC): National Committee for Quality Assurance (NCQA); 2015 Oct 1. 12 p.

For more information, contact the National Committee for Quality Assurance (NCQA) at 1100 13th Street, NW, Suite 1000, Washington, DC 20005; Phone: 202-955-3500; Fax: 202-955-3599; Web site: www.ncqa.org External Web Site Policy.

NQMC Status

This NQMC summary was completed by ECRI on June 16, 2006. The information was not verified by the measure developer.

This NQMC summary was updated by ECRI Institute on June 20, 2008. The information was verified by the measure developer on August 6, 2008.

This NQMC summary was updated by ECRI Institute on March 16, 2009. The information was not verified by the measure developer.

This NQMC summary was updated by ECRI Institute on May 28, 2010, October 17, 2011, November 29, 2012, August 5, 2013, April 23, 2014, May 5, 2015, and again on March 18, 2016.

Copyright Statement

This NQMC summary is based on the original measure, which is subject to the measure developer's copyright restrictions.

Content adapted and reproduced with permission from the National Committee for Quality Assurance (NCQA). HEDIS® is a registered trademark of NCQA. HEDIS measures and specifications were developed by and are owned and copyrighted by NCQA. HEDIS measures and specifications are not clinical guidelines and do not establish a standard of medical care. NCQA makes no representations, warranties, or endorsement about the quality of any organization or physician that uses or reports performance measures and NCQA has no liability to anyone who relies on such measures or specifications. Limited proprietary coding is contained in the measure specifications for convenience. Users of the proprietary code sets should obtain all necessary licenses from the owners of these code sets. NCQA disclaims all liability for use or accuracy of any coding contained in the specifications.

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