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Philip Renner, MBA, Measures Development, National Committee for Quality Assurance (NCQA), 2000 L St., N.W., Suite 500, Washington, DC 20036, (202) 955-1592, renner@ncqa.org and Russell Mardon, PhD, Research and Analysis, NCQA, 2000 L Street, NW, Suite 500, Washington, DC 20036.
Objective To evaluate the effectiveness of assessment and treatment of osteoporosis in women enrolled in Medicare+Choice plans, and to test the deployment of a potential new HEDIS" measure for M+C plans.
Design Observational study conducted in five M+C plans. A clinical expert panel was convened to develop measurement specifications based on existing guidelines. Analyses were run to calculate followup rates, and to determine the effects of prior treatment, use of HRT, and fracture site on rates of followup.
Findings Among patients who had not been receiving treatment for osteoporosis, between 11% and 14% of patients received appropriate followup after fracture. Including those patients being treated with medication at the time of fracture, the rate of appropriate followup increased to between 30% and 41%. Of those patients on medication at the time of fracture, 64% were taking HRT.
Conclusions Fewer than 15% of patients over 65 who are not on treatment for osteoporosis and suffer a fracture receive appropriate followup. Performance is higher when including patients being treated at the time of fracture, but is still well below optimal rates and is confounded by the use of HRT in this population.
Implications Despite availability of effective assessment methods and treatments for osteoporosis, physicians are not following up in a manner consistent with guidelines. Performance measurement for appropriate followup of fracture in older women can be used to highlight low followup rates and to improve assessment and treatment of osteoporosis in this population.
Learning Objectives:
Keywords: Managed Care, Frail Elderly
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: National Committee for Quality Assurance
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.