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  • Measure Summary
  • NQMC:010394
  • Jan 2015
  • NQF-Endorsed Measure

Vascular care: percentage of patients 18 to 75 years of age who have IVD with optimally managed modifiable risk factors.

MN Community Measurement. Data collection guide: 2016 optimal vascular care (01/01/2015 to 12/31/2015 dates of service). Minneapolis (MN): MN Community Measurement; 2015. 42 p.

View the original measure documentation External Web Site Policy

This is the current release of the measure.

This measure updates a previous version: Data collection guide: optimal vascular care 2014 (01/01/2013 to 12/31/2013 dates of service). Minneapolis (MN): MN Community Measurement; 2013 Dec 19. 51 p.

Primary Measure Domain

Clinical Quality Measures: Outcome

Secondary Measure Domain

Clinical Quality Measure: Process

Description

This measure is used to assess the percentage of patients 18 to 75 years of age who had a diagnosis of ischemic vascular disease (IVD) and whose IVD was optimally managed during the measurement period as defined by achieving ALL of the following:

  • Blood pressure less than 140/90 mmHg
  • On statin medication, unless allowed contraindications or exceptions are present
  • Non-tobacco user
  • On daily aspirin or anti-platelet medication, unless allowed contraindications or exceptions are present

Rationale

According to the Minnesota Department of Health, vascular disease is a high impact clinical condition in Minnesota. More than 20% of all deaths in Minnesota are due to heart disease and more than 7% are due to stroke, making them the second and third leading causes of death, respectively, in the state behind cancer. Inpatient hospitalization charges alone in Minnesota were $1.7 billion for heart disease patients and $318 million for stroke patients in 2007. According to the American Heart Association, nearly 84 million Americans have cardiovascular disease. In every year since 1900 (except the 1918 influenza pandemic), cardiovascular disease accounted for more deaths than any other major cause of death in the United States. In 2006, cardiovascular disease claimed one of every 2.9 deaths in the United States.

Evidence for Rationale

Larson J. (Manager, Health Care Measure Development, MN Community Measurement, Minneapolis, MN). Personal communication. 2015 Dec 8.  1 p.

Primary Health Components

Ischemic vascular disease (IVD); modifiable risk factors; blood pressure; statin medication, tobacco use; aspirin

Denominator Description

The eligible population:

  • 18 to 75 years of age as the start of January 1 of the measurement period
  • Patients identified as having a diagnosis of ischemic vascular disease (IVD) who had at least two face-to-face visits with an eligible provider in an eligible specialty with a diagnosis of IVD during the current or prior measurement period
  • At least one face-to-face visit with an eligible provider in an eligible specialty for any reason during the measurement period

See the related "Denominator Inclusions/Exclusions" field.

Numerator Description

The number of patients in the denominator whose ischemic vascular disease (IVD) was optimally managed during the measurement period as defined by achieving ALL of the following:

  • The most recent blood pressure in the measurement period has a systolic value of less than 140 mmHg AND a diastolic value of less than 90 mmHg
  • On statin medication, unless allowed contraindications or exceptions are present
  • Patient is a non-tobacco user
  • On daily aspirin or anti-platelet medication, unless allowed contraindications or exceptions are present

See the related "Numerator Inclusions/Exclusions" field.

Type of Evidence Supporting the Criterion of Quality for the Measure

  • A formal consensus procedure, involving experts in relevant clinical, methodological, public health and organizational sciences

Additional Information Supporting Need for the Measure

Unspecified

Extent of Measure Testing

MN Community Measurement (MNCM) conducts validity testing to determine if quality measures truly measure what they are designed to measure, and conducts reliability testing to determine if measures yield stable, consistent results. Validity testing is done to see if the concept behind the measure reflects the quality of care that is provided to a patient and if the measure, as specified, accurately assesses the intended quality concept. Reliability testing is done to see if calculated performance scores are reproducible.

Evidence for Extent of Measure Testing

MN Community Measurement. Measure testing. [internet]. Minneapolis (MN): MN Community Measurement; [accessed 2015 Nov 12].

State of Use

Current routine use

Current Use

External oversight/State government program

Internal quality improvement

Pay-for-performance

Public reporting

Measurement Setting

Ambulatory/Office-based Care

Hospital Outpatient

Professionals Involved in Delivery of Health Services

Advanced Practice Nurses

Physician Assistants

Physicians

Least Aggregated Level of Services Delivery Addressed

Clinical Practice or Public Health Sites

Statement of Acceptable Minimum Sample Size

Specified

Target Population Age

Age 18 to 75 years

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

Measurement period: January 1 through December 31

Denominator Sampling Frame

Patients associated with provider

Denominator (Index) Event or Characteristic

Clinical Condition

Encounter

Patient/Individual (Consumer) Characteristic

Denominator Time Window

Time window brackets index event

Denominator Inclusions/Exclusions

Inclusions
The eligible population:

  • 18 to 75 years of age as the start of January 1 of the measurement period
  • Patients identified as having a diagnosis of ischemic vascular disease (IVD) who had at least two face-to-face visits with an eligible provider in an eligible specialty with a diagnosis of IVD (Ischemic Vascular Disease Value Set*) during the current or prior measurement period
  • At least one face-to-face visit with an eligible provider in an eligible specialty for any reason during the measurement period

*Value Set: A set of administrative codes used to define a concept related to the measure construct (e.g., denominator, exclusions) using standard coding systems (e.g., International Classification of Diseases, Tenth Revision [ICD-10], Current Procedural Terminology [CPT], Logical Observation Identifiers Names and Codes [LOINC]). Value Set Dictionaries are available from the MN Community Measurement Web site External Web Site Policy.

Exclusions
The following exclusions are allowed to be applied to the eligible population:

  • Patient was a permanent nursing home resident at any time during the measurement period
  • Patient was in hospice or receiving palliative care at any time during the measurement period
  • Patient died prior to the end of the measurement period
  • Documentation that diagnosis was coded in error

Exclusions/Exceptions

Unspecified

Numerator Inclusions/Exclusions

Inclusions
The number of patients whose ischemic vascular disease (IVD) was optimally managed during the measurement period as defined by achieving ALL of the following:

  • The most recent blood pressure in the measurement period has a systolic value of less than 140 mmHg AND a diastolic value of less than 90 mmHg
  • On statin medication, unless allowed contraindications or exceptions are present
  • Patient is a non-tobacco user
  • On daily aspirin or anti-platelet medication, unless allowed contraindications or exceptions are present

Note: Refer to the original measure documentation for lists of aspirin and anti-platelet containing products and accepted contraindications.

Exclusions
Unspecified

Numerator Search Strategy

Fixed time period or point in time

Data Source

Administrative clinical data

Electronic health/medical record

Paper medical record

Type of Health State

Physiologic Health State (Intermediate Outcome)

Instruments Used and/or Associated with the Measure

  • 2016 Optimal Vascular Care Measure Patient Flow Chart
  • Statin Use Component Flow Chart

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

2016 optimal vascular care.

Measure Collection Name

Optimal Vascular Care

Submitter

MN Community Measurement - Health Care Quality Collaboration

Developer

MN Community Measurement - Health Care Quality Collaboration

Funding Source(s)

Unspecified

Composition of the Group that Developed the Measure

Unspecified

Financial Disclosures/Other Potential Conflicts of Interest

Unspecified

Endorser

National Quality Forum

NQF Number

0076

Date of Endorsement

2014 May 28

Adaptation

This measure was not adapted from another source.

Date of Most Current Version in NQMC

2015 Jan

Measure Maintenance

Unspecified

Date of Next Anticipated Revision

Unspecified

Measure Status

This is the current release of the measure.

This measure updates a previous version: Data collection guide: optimal vascular care 2014 (01/01/2013 to 12/31/2013 dates of service). Minneapolis (MN): MN Community Measurement; 2013 Dec 19. 51 p.

Source(s)

MN Community Measurement. Data collection guide: 2016 optimal vascular care (01/01/2015 to 12/31/2015 dates of service). Minneapolis (MN): MN Community Measurement; 2015. 42 p.

Measure Availability

Source available from the MN Community Measurement Web site External Web Site Policy.

For more information, contact MN Community Measurement at 3433 Broadway St. NE, Broadway Place East, Suite #455, Minneapolis, MN 55413; Phone: 612-455-2911; Web site: http://mncm.org External Web Site Policy; E-mail: info@mncm.org.

Companion Documents

The following is available:

  • Snowden AM, Xiong M, Ghere E, Johnson J. 2015 health care quality report. Minneapolis (MN): MN Community Measurement; 2016. 419 p. This document is available from the MN Community Measurement Web site External Web Site Policy.

NQMC Status

This NQMC summary was completed by ECRI Institute on March 13, 2014. The information was verified by the measure developer on June 19, 2014.

This NQMC summary was updated by ECRI Institute on March 21, 2016. The information was not verified by the measure developer.

Copyright Statement

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

This measure is subject to review and may be revised or rescinded at any time by MN Community Measurement (MNCM). The measure may not be altered without the prior written approval of MNCM. Measures developed by MNCM, while copyrighted, can be reproduced and distributed without modification for noncommercial purposes (e.g., use by health care providers in connection with their practices). Commercial use is defined as the sale, license, or distribution of the measure for commercial gain, or incorporation of the measure into a product of service that is sold, licensed or distributed for commercial gain. Commercial use of the measure requires a license agreement between the user and MNCM.

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