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Table 1 Definitions and data sources of the QICH indicator set, 2007-2009.

From: Community healthcare in Israel: quality indicators 2007-2009

Healthcare quality indicators Domain Data sourcea Target population
Asthma    
Use of appropriate control medication for individuals with persistent asthma b Percentage of individuals with persistent asthma who purchased at least three asthma control medications in three different months during the measurement year Treatment Pharmacy claims 5-56 years
Influenza vaccination for individuals with persistent asthma b Percentage of individuals with persistent asthma who received the influenza vaccination during the winter months of the measurement year (plus two months of subsequent year) Treatment Pharmacy claims 5-56 years
Cancer screening    
Breast cancer screening: Mammography Percentage of women who had a mammogram during the past two years Primary prevention Test records 51-74 years
Colon cancer screening: Fecal occult blood test Percentage of individuals who had a fecal occult blood test during the measurement yearc Primary prevention Laboratory results 50-74 years
Cardiovascular health    
Blood pressure documentation Percentage of individuals with blood pressure documentation Primary prevention Medical records 20-54 years - documentation during past five years; 55-74 years - documentation during measurement year
Blood pressure assessment Percentage of individuals with adequate blood pressure control (≤ 140/90 mmHg) Primary prevention Medical records 20-54 years - documentation during past five years; 55-74 years - documentation during measurement year
Body mass index (BMI) documentation • Percentage of individuals with BMI documentation - adolescents • Percentage of individuals with BMI documentation - adults Primary prevention Medical records 14-18 years - documentation during past three years; 20-64 years - documentation during past five years; 65-74 years - documentation of weight during the measurement year and height during the past five years
Cholesterol documentation Percentage of individuals with cholesterol documentation Primary prevention Laboratory results 35-54 years - documentation during past five years; 55-74 years - documentation during measurement year
Cholesterol assessment Percentage of individuals with adequate low-density lipoprotein cholesterol control (≤ 130 mg/dL) Primary prevention Laboratory results 35-54 years - documentation during past five years; 55-74 years - documentation during measurement year
Treatment with statins and other low-density lipoprotein (LDL) modifying medications following a coronary intervention d Percentage of individuals following a coronary event who purchased at least three LDL-modifying medications in three different months during the measurement year Treatment Pharmacy claims, Hospital procedures 35-74 years
Treatment with angiotensin-converting enzyme inhibitors (ACEI) or angiotensin receptor blockers (ARB) following a coronary intervention d Percentage of individuals following a coronary event who purchased at least three ACEI/ARB medications in three different months during the measurement year Treatment Pharmacy claims, Hospital procedures 35-74 years
Treatment with beta blockers following a coronary intervention d Percentage of individuals following a coronary event who purchased at least three ACEI/ARB medications in three different months during the measurement year Treatment Pharmacy claims, Hospital procedures 35-74 years
Cholesterol assessment following a coronary intervention d Percentage of individuals following a coronary event with adequate cholesterol control (≤ 100 mg/dL) during the measurement year Effectiveness of care Laboratory results, Hospital procedures 35-74 years
Child health    
Anemia screening in infants Percentage of children who had a hemoglobin test during the measurement year Primary prevention Laboratory results 1 year olds
Diabetes    
Blood pressure documentation Percentage of patients with diabetes mellitus with blood pressure documentation during the measurement year Treatment Laboratory results 18+ years
Body mass index (BMI) documentation Percentage of patients with diabetes mellitus with BMI documentation Treatment Medical records 18+ years - documentation of weight during the measurement year and height over the past five years
Cholesterol documentation Percentage of patients with diabetes mellitus with cholesterol documentation during the measurement year Treatment Laboratory results All ages
Eye care documentation Percentage of patients with diabetes mellitus with documentation of an eye examination during the measurement year Treatment Medical records All ages
Glycemic control documentation Percentage of patients with diabetes mellitus with glycemic control (HbA1c) documentation during the measurement year Treatment Laboratory results All ages
Kidney function documentation Percentage of patients with diabetes mellitus with microalbuminurea documentation during the measurement year Treatment Laboratory results All ages
Influenza vaccination Percentage of patients with diabetes mellitus who received the influenza vaccination during the winter months of the measurement year (plus two months of subsequent year) Treatment Pharmacy claims 5+ years
Blood pressure assessment Percentage of patients with diabetes mellitus with adequate blood pressure control (≤ 130/80 mmHg) during the measurement year Effectiveness of care Medical records 18+ years
Cholesterol assessment Percentage of patients with diabetes mellitus with adequate low-density lipoprotein cholesterol control (≤ 100 mg/dL) during the measurement year Effectiveness of care Laboratory results All ages
Glycemic control assessment Percentage of diabetics with adequate glycemic control (HbA1c ≤ 7%) during the measurement year Effectiveness of care Laboratory results All ages
Assessment of inadequate glycemic control Percentage of patients with diabetes mellitus with inadequate glycemic control (HbA1c > 9%) during the measurement year Effectiveness of care Laboratory results All ages
Treatment with insulin for individuals with inadequate glycemic control Percentage of patients with diabetes mellitus with inadequate glycemic control (HbA1c > 9%) and purchased insulin at least once during the measurement year Effectiveness of care Laboratory results, Pharmacy claims All ages
Immunizations for older adults    
Influenza vaccination for older adults Percentage of older adults who received the influenza vaccination during the winter months of the measurement year (plus two months of subsequent year) Primary prevention Pharmacy claims 65+ years
  1. BMI, body mass index; LDL, low density lipoproteins; ACEI, angiotensin-converting enzyme inhibitors; ARB, angiotensin receptor blockers; HbA1c, glycated hemoglobin; QICH, National Program for Quality Indicators in Community Healthcare in Israel
  2. aAll data were collected from each MCO's electronic records. Numerator and denominator data for each measure were collected by the National QICH project to create the national rate.
  3. b Persistent asthma is defined by asthma medication purchases. These medications include control medication (immunomodulators, inhaled corticosteroids, leukotriene modifiers, long-acting beta-2 agonists, methylxanthines, mast cell stabilizers), as well as relief medications (short-acting beta-2 agonists, anticholinergics).
  4. c Excluding those who underwent a colonoscopy during the past five years.
  5. dA coronary intervention is defined as having undergone coronary artery bypass surgery or cardiac catheterization during the past five years.