Application of HEDIS measures within a Veterans Affairs medical center.
OBJECTIVE
To pilot test 3 HEDIS performance measures--beta-blocker treatment after a heart attack, ambulatory follow-up after hospitalization for mental illness, and cervical cancer screening--within a Veterans Affairs (VA) medical center.


METHODS
Retrospective review of administrative data. For 1 performance measure (beta-blocker treatment after a heart attack), a medical record review was performed for purposes of data validation.


METHODS
The eligibility criteria differed by the performance measure. Eligible populations for the first, second, and third performance measures, respectively, were: (1) patients aged 35 years or older who were hospitalized and discharged alive with a primary diagnosis of acute myocardial infarction in calendar year 1996; (2) patients hospitalized for treatment of selected mental health disorders in fiscal year 1997; and (3) female patients aged 21 to 64 years enrolled in VA primary care clinics during fiscal years 1995-1997. We collected data in accordance with HEDIS 3.0 specifications for administrative data.


RESULTS
With few or no modifications to the HEDIS specifications, we successfully adapted the HEDIS performance measures to the VA setting. We found that, in some areas, VA performance compared favorably to or exceeded that of the private sector. We also identified opportunities for quality improvement.


CONCLUSIONS
HEDIS performance measures can be applied within the VA system, both as a means of quantifying performance and as a tool for improving the quality of care. Adopting HEDIS measures would provide additional value to VA medical centers by allowing them to compare their performance with that of private-sector providers.
Mencke
N M
NM
Health Services Research and Development Program, Atlanta Veterans Affairs Medical Center, Decatur 30033, USA. nancy.mencke@med.va.gov
Alley
L G
LG
Etchason
J
J
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000328:Adult; D000553:Ambulatory Care; D005260:Female; D006787:Hospitals, Veterans / Q000458:organization & administration / Q000592:standards*; D006801:Humans; D001523:Mental Disorders / Q000628:therapy; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy; D010865:Pilot Projects; D011785:Quality Assurance, Health Care; D012189:Retrospective Studies; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis
D000319:Adrenergic beta-Antagonists