Part 1: Types of Measures Structural measures give consumers a sense of a health care provider’s capacity, systems, and processes to provide high-quality care. Process measures indicate what a provider does to maintain or improve health, either for healthy people or for those diagnosed with a health care condition. These measures typically reflect generally accepted recommendations for clinical practice. Outcome measures reflect the impact of the health care service or intervention on the health status of patients.

Understanding Health Insurance: A Guide to Billing and Reimbursement
14th Edition
ISBN:9781337679480
Author:GREEN
Publisher:GREEN
Chapter16: Tricare
Section: Chapter Questions
Problem 5R
icon
Related questions
Question

Part 1: Types of Measures

Structural measures give consumers a sense of a health care provider’s capacity, systems, and processes to provide high-quality care.

Process measures indicate what a provider does to maintain or improve health, either for healthy people or for those diagnosed with a health care condition. These measures typically reflect generally accepted recommendations for clinical practice.

Outcome measures reflect the impact of the health care service or intervention on the health status of patients. 

 

Metric Name

Description

Metric Type: Structure, Process or Outcome?

Breast Cancer Screening Rate

The percent of women aged 50-74 who had a mammogram to screen for breast cancer during the year.

Process

Controlling High Blood Pressure

The percent of adults, aged 18 to 84 with a diagnosis of hypertension, with blood pressure that is adequately controlled (<140/90 mm Hg)

Outcome

Board Certified Physicians 

The number of board certified physicians who provide services at a hospital

Structure

Post-Surgical Complication Rate

The number of complications (infections, injury, etc.) within 10 days of surgery, per 100 surgeries.

Structure

Comprehensive Diabetes Care: Diabetic Eye Exams

The number of adults 18-75 years of age with diabetes (type 1 or 2) who completed a retinal eye exam during the year.

Process

Comprehensive Diabetes Care: HbA1C under 8%

The number of adults 18-75 years of age with diabetes (type 1 or 2) whose HbA1c is adequately controlled (<8%) during the year.

Outcome

 

Part 2: Metric Definitions 

Using the metric descriptions above, create descriptive definitions for each metric numerator and denominator.

Metric Name

Numerator - define

Denominator – define

Breast Cancer Screening Rate

   

Controlling High Blood Pressure

   

Post-Surgical Complication Rate

   

Comprehensive Diabetes Care: A1C under 8%

   

 

Expert Solution
steps

Step by step

Solved in 3 steps

Blurred answer
Knowledge Booster
Environmental health & hazards
Learn more about
Need a deep-dive on the concept behind this application? Look no further. Learn more about this topic, biology and related others by exploring similar questions and additional content below.
Recommended textbooks for you
Understanding Health Insurance: A Guide to Billin…
Understanding Health Insurance: A Guide to Billin…
Health & Nutrition
ISBN:
9781337679480
Author:
GREEN
Publisher:
Cengage
Essentials Health Info Management Principles/Prac…
Essentials Health Info Management Principles/Prac…
Health & Nutrition
ISBN:
9780357191651
Author:
Bowie
Publisher:
Cengage
3-2-1 Code It
3-2-1 Code It
Biology
ISBN:
9781337660549
Author:
GREEN
Publisher:
Cengage
Case Studies In Health Information Management
Case Studies In Health Information Management
Biology
ISBN:
9781337676908
Author:
SCHNERING
Publisher:
Cengage
Comprehensive Medical Assisting: Administrative a…
Comprehensive Medical Assisting: Administrative a…
Nursing
ISBN:
9781305964792
Author:
Wilburta Q. Lindh, Carol D. Tamparo, Barbara M. Dahl, Julie Morris, Cindy Correa
Publisher:
Cengage Learning
Intro To Health Care
Intro To Health Care
Health & Nutrition
ISBN:
9781337338295
Author:
Mitchell
Publisher:
Cengage