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Eye examinations for VA patients with diabetes: standardizing performance measures
D Jones1, A Hendricks, C Comstock
1Center for Health Quality, Outcomes and Economic Research, Edith Nourse Rogers Memorial Veterans Hospital, Bedford, MA 01730, USA. djonesl@bu.edu
Summary
The Health Plan Employer Data and Information Set (HEDIS) can calculate eye exam rates for diabetic patients using Veterans Health Administration (VA) data. However, data limitations necessitate caution when interpreting performance measures across healthcare sectors.
Area of Science:
- Health Services Research
- Diabetes Care
- Ophthalmology
Background:
- Diabetic patients require regular eye exams to prevent vision loss.
- The Veterans Health Administration (VA) serves a large diabetic population.
- Standardized performance measures are crucial for quality improvement in healthcare.
Purpose of the Study:
- To assess the feasibility of using Health Plan Employer Data and Information Set (HEDIS) measures for eye exams in diabetic VA patients.
- To evaluate the utility of VA administrative data for performance measurement.
Main Methods:
- Calculated HEDIS-defined denominators and numerators for eye exams in diabetic VA patients.
- Utilized alternative specifications for patient identification and eye exam capture.
- Supplemented VA data with pharmacy and Medicare claims for comprehensive utilization assessment.
Main Results:
- The national average annual HEDIS-defined eye exam rate in the VA was 26% in fiscal 1997, compared to 39% for managed care organizations.
- Medicare utilization increased the eye exam rate by 15 percentage points at selected VA facilities.
- Over two years, at least two-thirds of diabetic VA patients received an eye exam through VA or Medicare.
Conclusions:
- HEDIS measures for diabetic eye exams are calculable using VA administrative data.
- Limitations exist in accurately identifying all diabetic patients and appropriate eye exams within data systems.
- Caution is advised when interpreting performance measurement results across different healthcare sectors due to data system constraints.
