Performance Measurement Network

Question: Questions about sampling?

Answer:

Continue to “randomly” select your inpatient sample and your outpatient sample (2 separate patient groups) using the specified sampling methodology for heart failure. Remember that you always start with the initial inpatient population using the ICD-9-CM Prinicpal Diagnosis Codes on Table 2.1, ICD-9-CM Other Procedure Codes on Table 2.2, patient age >/= 18 years, and LOS < 120 days. For the outpatient population, replace LOS with discharge status and add E/M code and encounter date. These algorithms identify the whole initial patient population.

When collecting data, it may be easier to abstract measures that use the entire heart failure population first (e.g., Advance Directives measures), and abstract measures that add other inclusions/exclusions to the denominator population for that measure. For example, the medication measures and ICD/CRT measures restrict the denominator population to a more limited group of heart failure patients, (i.e. LVSD < 35%, LVSD < 40%). Check the denominator statements and included/excluded populations - denominator for each measure to make sure that only the HF patients meeting the specified data elements are included in these measures.

We will run the cases submitted for Nov and Dec at the end of January to see if there is a problem with the denominator size for ICD/CRT measures 05a and 05b. Depending on the data, we may we need to need to adjust the sampling methodology for some measures if the denominator size is too small.

Question Details
Focus area(s): Chart Abstracted Measure Specifications – Clinical
Related documents: ACHF,
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