title: An Assessment of the AGA and CCFA Quality Indicators in a Sample of Patients Diagnosed with Inflammatory Bowel Disease.
abstract: BACKGROUND
  Inflammatory bowel disease (IBD) is a chronic relapsing disease characterized by activation of the mucosal immune system and inflammation of the gastrointestinal tract. Management of IBD places a significant burden on the health care system because of the complexity of treatment, variability in patient outcomes, and chronic nature of the disease.
  
  
  OBJECTIVE
  To investigate the American Gastroenterological Association (AGA) and Crohn's and Colitis Foundation of America's (CCFA) quality measurement sets in a sample of IBD patients.
  
  
  METHODS
  Fourteen quality measures were restated for application to a claims database and calculated using Optum Clinformatics DataMart database. Selected measures were calculated over calendar year 2011.
  
  
  RESULTS
  Performance measures ranged from 0.4% for AGA measure 9, prophylaxis for venous thromboembolism, to 66.9% for AGA measure 8, testing for Clostridium difficile. CCFA outcome measures ranged from 0.6% qualifying for CCFA O10, report of fecal incontinence, to 32.9% for CCFA O1, prednisone usage. In addition to Clostridium difficile testing, the use of appropriate corticosteroid-sparing therapy (51.1%) and testing for latent tuberculosis before initiating anti-tumor necrosis factor therapy (45.0%) were the highest achieved measures.
  
  
  CONCLUSIONS
  This is the first examination of IBD quality measures using administrative claims. Rates of achievement across measures were variable and likely affected by the ability to calculate certain measures with claims data. Future studies should further examine measurement of IBD quality indicators in claims data to assess the validity of claims-based analyses and to ascertain whether measure attainment translates into better overall health or IBD-related outcomes.
authors.affiliation: Health Analytics, 9200 Rumsey Rd., Ste. 215, Columbia, MD 21045. joseph.tkacz@healthanalytic.com.
authors.forename: Joseph
authors.initials: J
authors.lastname: Tkacz
authors.forename: Brenna L
authors.initials: BL
authors.lastname: Brady
authors.forename: Roxanne
authors.initials: R
authors.lastname: Meyer
authors.forename: Jennifer H
authors.initials: JH
authors.lastname: Lofland
authors.forename: Charles
authors.initials: C
authors.lastname: Ruetsch
authors.forename: Nayantara
authors.initials: N
authors.lastname: Coelho-Prabhu
mesh_terms: D000328:Adult; D016208:Databases, Factual; D005260:Female; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000175:diagnosis / Q000628:therapy; D007345:Insurance Claim Review; D008297:Male; D008875:Middle Aged; D019984:Quality Indicators, Health Care / Q000592:standards*; D012955:Societies, Medical