NCQA sets new diabetes measures, but not for kids
Small sample sizes force shift in measurements
Health plans will begin collecting data voluntarily for six new diabetes measures as a part of Health Plan Employer Data and Information Set (HEDIS) 1999, the National Committee for Quality Assurance (NCQA) in Washington, DC, announced. Those represent the organization’s first comprehensive set of measures focused on one disease and will become mandatory in 2000. (For a list of measures, see box, p. 139.)
However, an effort to implement similar diabetes measures for children was abandoned due to problems with inadequate sample sizes.
"In order to do a scientific survey, [health plans] have to sample several hundred people. By definition that means those kids with diabetes won’t be there," says Larry Deeb, MD, a pediatric gastroenterologist and a member of the Diabetes Quality Improvement Project (DQIP).
DQIP is a joint project of NCQA, the Health Care Financing Administration, the American Diabetes Association, and the Foundation for Accountability.
While diabetes is one of the more common chronic illnesses afflicting children, only about 100,000 children nationwide suffer from the disease, Deeb says. In contrast, an estimated 16 million adult Americans have diabetes, and about half of them of them remain undiagnosed.
Trying to identify sufficient samples of children with diabetes would be prohibitively expensive for managed care organizations, Deeb says. Still, NCQA can assess care of diabetic children and those with other chronic illnesses through surveys of parents, he says. "They are trying to come at this question in a more generic sense."
The final release of HEDIS 1999 in September contained few surprises. Plans will use a HEDIS version of the Consumer Assessment of Health Plans, including one geared toward parents of pediatric patients, rather than the previous Member Satisfaction Survey. HEDIS 1999 also includes new measures on controlling low density lipoprotein (LDL) among patients with heart problems and management of patients suffering from moderate to severe depression.
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