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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.
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.
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.
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.
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.