Health Resources and Services Administration HIV/AIDS Bureau Performance Measures
Overview
The HIV/AIDS Bureau has revised its performance measure portfolio. The updated portfolio is more focused on critical areas of HIV care and treatment, and, as of November 6, 2013, it contains fewer performance measures. The revisions include:
- Identifying core performance measures that are most critical to the care and treatment of people living with HIV
- Combining measures to address people of all ages living with HIV
- Aligning measures with U.S. Department of Health and Human Services (HHS) priorities, guidelines, and initiatives
- Promoting relevant performance measures used in other federal programs
- Archiving performance measures
Unlike the previous version wherein the portfolio included three groups of core measures intended for various levels of programs' ability to implement, the updated portfolio features a set of Core Clinical Performance Measures and consolidates several of the previous clinical measures into four categories: All-Age Clinical Performance Measures , Adult and Adolescent Clinical Performance Measures , HIV-Exposed Children, and HIV-Infected Children. The Core performance measures emphasize the essential aspects of HIV care and treatment and align with the milestones along the HIV care continuum).
The Medical Case Management Performance Measures target all clients, and focus on two key issues: care plans and medical visits. Medical case management programs are encouraged to utilize the core clinical performance measures as appropriate.
The Oral Health Performance Measures target all clients. The measures are intended for use by programs providing direct oral health services.
The AIDS Drug Assistance Program (ADAP) Measures are intended for use by the ADAP. Four measures are included and target all clients, regardless of age.
The Systems-Level Performance Measures address aspects of access and entry to care and may be utilized by any system or network.
Two sets of measures not reproduced here (HIV-Exposed Children and HIV-Infected Children) address a range of clinical, social, and system issues for programs that serve pediatric clients. In addition, the archived performance measures are available for reference on the HRSA HAB website.
The HIV/AIDS Bureau encourages all organizations providing HIV services to use the Bureau's revised performance measures, including the Core performance measures, and select the appropriate measures for their own portfolio. Measure selection is based on the services that are provided, prominent clinical issues, and patient demographics. The HIV/AIDS Bureau does not promote using every performance measure available because the activities needed to implement performance measurement (e.g., collecting, analyzing, and reviewing data) can be costly. Individual programs are recommended to consider having some measures that are collected and analyzed more frequently (e.g., every 2 months or quarterly) and others that are collected and reviewed less frequently (e.g., every 6 months or annually). Grantees are not required to use all performance measures. Given the emphasis on using performance measures to improve patient health, grantees may trend performance measures over time and analyze performance measures for disparities in care.
| Measure | Definition |
|---|---|
| For details on these measurements, including data elements, national comparison data, and supporting references, see Core Performance Measures . HRSA HIV/AIDS Bureau. November 2013. | |
| HIV Viral Load Suppression | Percentage of patients, regardless of age, with a diagnosis of HIV with an HIV viral load of <200 copies/mL at last HIV viral load test during the measurement year |
| Prescription of HIV Antiretroviral Therapy | Percentage of patients, regardless of age, with a diagnosis of HIV who were prescribed antiretroviral therapy for the treatment of HIV infection during the measurement year |
| HIV Medical Visit Frequency | Percentage of patients, regardless of age, with a diagnosis of HIV who had at least one medical visit in each 6-month period of the 24-month measurement period with a minimum of 60 days between medical visits |
| Gap in HIV Medical Visits | Percentage of patients, regardless of age, with a diagnosis of HIV who did not have a medical visit in the last 6 months of the measurement year |
| Pneumocystis jiroveci Pneumonia (PCP) Prophylaxis | Percentage of patients, aged 6 weeks or older with a diagnosis of HIV/AIDS, who were prescribed Pneumocystis jiroveci pneumonia (PCP) prophylaxis |
| Measure | Definition |
|---|---|
| For details on these measurements, including data elements, national comparison data, and supporting references, see All Ages Performance Measures . HRSA HIV/AIDS Bureau. November 2013. | |
| CD4 Cell Count | Percentage of patients, aged 6 months and older with a diagnosis of HIV/AIDS, with at least two CD4 cell counts or percentages performed during the measurement year at least 3 months apart |
| HIV Drug Resistance Testing Before Initiation of Therapy | Percentage of patients, regardless of age, with a diagnosis of HIV who had an HIV drug resistance test performed before initiation of HIV antiretroviral therapy if therapy started during the measurement year |
| Influenza Immunization | Percentage of patients, aged 6 months and older seen for a visit between October 1 and March 31, who received an influenza immunization OR who reported previous receipt of an influenza immunization |
| Lipid Screening | Percentage of patients, regardless of age, with a diagnosis of HIV who were prescribed HIV antiretroviral therapy and who had a fasting lipid panel during the measurement year |
| Tuberculosis Screening | Percentage of patients aged 3 months and older with a diagnosis of HIV/AIDS, for whom there was documentation that a tuberculosis screening test was performed and results interpreted (for tuberculin skin tests) at least once since the diagnosis of HIV infection |
| Viral Load Monitoring | Percentage of patients, regardless of age, with a diagnosis of HIV with a viral load test performed at least every 6 months during the measurement year |
| Measure | Definition |
|---|---|
| For details on these measurements, including data elements, national comparison data, and supporting references, see Adult and Adolesent Performance Measures . HRSA HIV/AIDS Bureau. November 2013. | |
| Cervical Cancer Screening | Percentage of female patients with a diagnosis of HIV who have a Pap screening in the measurement year |
| Chlamydia Screening | Percentage of patients with a diagnosis of HIV at risk of sexually transmitted infections who had a test for chlamydia within the measurement year |
| Gonorrhea Screening | Percentage of patients with a diagnosis of HIV at risk of sexually transmitted infections who had a test for gonorrhea within the measurement year |
| Hepatitis B Screening | Percentage of patients, regardless of age, for whom hepatitis B screening was performed at least once since the diagnosis of HIV/AIDS or for whom there is documented infection or immunity |
| Hepatitis B Vaccination | Percentage of patients with a diagnosis of HIV who completed the vaccination series for hepatitis B |
| Hepatitis C Screening | Percentage of patients for whom hepatitis C screening was performed at least once since the diagnosis of HIV |
| HIV Risk Counseling | Percentage of patients with a diagnosis of HIV who received HIV risk counseling in the measurement year |
| Oral Exam | Percentage of patients with a diagnosis of HIV who received an oral exam by a dentist at least once during the measurement year |
| Pneumococcal Vaccination | Percentage of patients with a diagnosis of HIV who ever received pneumococcal vaccine |
| Preventive Care and Screening: Screening for Clinical Depression and Follow-Up Plan | Percentage of patients aged 12 years and older screened for clinical depression on the date of the encounter using an age-appropriate standardized depression screening tool AND, if positive, a follow-up plan is documented on the date of the positive screen |
| Preventive Care and Screening: Tobacco Use - Screening and Cessation Intervention | Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received cessation counseling intervention if identified as a tobacco user |
| Substance Abuse Screening | Percentage of new patients with a diagnosis of HIV who have been screened for substance use (alcohol and drugs) in the measurement year |
| Syphilis Screening | Percentage of adult patients with a diagnosis of HIV who had a test for syphilis performed within the measurement year |
| Measure | Definition |
|---|---|
| For details on these measurements, including data elements, national comparison data, and supporting references, see Medical Case Management Performance Measures . HRSA HIV/AIDS Bureau. November 2013. | |
| Care Plan | Percentage of medical case management patients, regardless of age, with a diagnosis of HIV who had a medical case management care plan developed and/or updated two or more times in the measurement year |
| Gap in HIV Medical Visits | Percentage of medical case management patients, regardless of age, with a diagnosis of HIV who did not have a medical visit in the last 6 months of the measurement year (that is documented in the medical case management record) |
| HIV Medical Visit Frequency | Percentage of medical case management patients, regardless of age, with a diagnosis of HIV who had at least one medical visit in each 6-month period of the 24-month measurement period with a minimum of 60 days between medical visits |
| Measure | Definition |
|---|---|
| For details on these measurements, including data elements, national comparison data, and supporting references, see Oral Heath Services Performance Measures . HRSA HIV/AIDS Bureau. November 2013. | |
| Dental and Medical History | Percentage of HIV-infected oral health patients who had a dental and medical health history (initial or updated) at least once in the measurement year |
| Dental Treatment Plan | Percentage of HIV-infected oral health patients who had a dental treatment plan developed and/or updated at least once in the measurement year |
| Oral Health Education | Percentage of HIV-infected oral health patients who received oral health education at least once in the measurement year |
| Periodontal Screening or Examination | Percentage of HIV-infected oral health patients who had a periodontal screen or examination at least once in the measurement year |
| Phase 1 Treatment Plan Completion | Percentage of HIV-infected oral health patients with a Phase 1 treatment plan that is completed within 12 months |
| Measure | Definition |
|---|---|
| For details on these measurements, including data elements, national comparison data, and supporting references, see AIDS Drug Assistance Performance Measures . HRSA HIV/AIDS Bureau. November 2013. | |
| Application Determination | Percent of ADAP applications approved or denied for new ADAP enrollment within 14 days (2 weeks) of ADAP receiving a complete application in the measurement year |
| Eligibility Recertification | Percentage of ADAP enrollees who are reviewed for continued ADAP eligibility two or more times in the measurement year |
| Formulary | Percentage of new antiretroviral classes that are included in the ADAP formulary within 90 days of the date of inclusion of new antiretroviral classes in the HHS Guidelines for the Use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents during the measurement year |
| Inappropriate Antiretroviral Regimen Components Resolved by ADAP | Percent of identified inappropriate antiretroviral regimen components prescriptions that are resolved by the ADAP program during the measurement year |
| Indicator | Definition |
|---|---|
| For details on these measurements, including data elements, national comparison data, and supporting references, see System-Level Performance Measures . HRSA HIV/AIDS Bureau. November 2013. | |
| Waiting Time for Initial Access to Outpatient/Ambulatory Medical Care | Percentage of Ryan White Program-funded outpatient/ambulatory care organizations in the system/network with a waiting time of 15 or fewer business days for a Ryan White Program-eligible patient to receive an appointment to enroll in outpatient/ambulatory medical care |
| HIV Test Results for PLWHA | Percentage of individuals who test positive for HIV who are given their HIV-antibody test results in the measurement year |
| HIV Positivity | Percentage of HIV positive tests in the measurement year |
| Late HIV Diagnosis | Percentage of patients with a diagnosis of Stage 3 HIV (AIDS) within 3 months of diagnosis of HIV |
| Linkage to HIV Medical Care | Percentage of patients who attended a routine HIV medical care visit within 3 months of HIV diagnosis |
| Housing Status | Percentage of patients with HIV diagnosis who were homeless or unstably housed in the 12-month measurement period |
References
- U.S. Department of Health and Human Services HIV/AIDS Program. HAB HIV Performance Measures . Accessed December 1, 2013.
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Abbreviations for Dosing Terminology
- BID
- twice daily
- BIW
- twice weekly
- IM
- intramuscular (injection), intramuscularly
- IV
- intravenous (injection), intravenously
- PO
- oral, orally
- Q2H, Q4H, etc.
- every 2 hours, every 4 hours, etc.
- QAM
- every morning
- QD
- once daily
- QH
- every hour
- QHS
- every night at bedtime
- QID
- four times daily
- QOD
- every other day
- QPM
- every evening
- TID
- three times daily
- TIW
- three times weekly