Measure Type: Efficiency

This quality measure aims to minimize the use of head computed tomography (CT) scans in both the Emergency Department (ED) and Hospital Medicine (HM) settings for patients presenting with seizures when they have a known history of seizure disorder and there is no new clinical evidence of head injury.

Percentage of patients receiving supportive care drugs (including colony stimulating factors, bone health, supplemental iron medications, and neurokinin 1 (NK1) receptor antagonist antiemetics) during the 14 days prior to and including the date of death.

Percentage of patients with cancer (solid tumors only) receiving any white cell growth factors with during the first cycle of low-risk chemotherapy.

Percentage of patients aged younger than 18 years with diagnosis of seizure that did not have a CT or MRI of the head ordered.

The measure calculates the percentage of a physician’s patients who have a continuity index of at least 0.7 (excluding patients with < 2 primary care visits during the measurement period). This is a physician-level measure for use in evaluating physician behavior; it leverages a previously validated continuity index that quantifies the extent to which patients experience continuity of provider in their primary care visits.

This measure evaluates the extent to which primary care physicians (PCPs) are supporting the continuity of care of their patients. High care continuity is shown to improve patient outcomes and physician well-being, is associated with decreased health care costs (total, ED, inpatient, primary care, and costs for specific conditions or treatments) and health care utilization (ED visits and hospitalizations). As a byproduct of building a trusting relationship over time, issues of equity and social risk can be addressed. Physicians who perform better are likely to have specific structures and processes in place that are conducive to allowing patients to achieve higher care continuity.

Compared to lower scores (e.g., 0.6 or lower), continuity index scores of 0.7 or higher have been associated with significantly lower Medicare expenditures and significantly lower odds of hospitalization.1

References:
1. Higher Primary Care Physician Continuity is Associated with Lower Costs and Hospitalizations. Bazemore et al. Annals of Family Medicine. 2018. 16, 492-497.

Percentage of patients aged 18 years or older, who undergo an elective procedure lasting 30 minutes or longer requiring inhalational general anesthesia who during the maintenance phase of the anesthetic have a total fresh gas flow less than or equal to 1 L/min (less than or equal to 2 L/min for Sevoflurane).