Performance indicators in women's health: incorporating women's health in the health plan employer data and information set (HEDIS).

The Health plan Employer Data and Information Set (HEDIS) is limited in its scope of women's health-related performance measures. Realizing this, the National Committee for Quality Assurance developed the Women's Health Measurement Advisory Panel (MAP) to expand and develop HEDIS measures to better represent women's health issues. This paper outlines the development of several new women's health-related performance measures and highlights the complexities of creating new measures to assess the quality of care provided to women through our nation's managed care organizations.     

Applying HEDIS clinical measures to community health centers: a feasibility study

Since participation in managed care is critical for community health centers' (CHCs) survival, centers must demonstrate their good performance to purchasers (e.g., state Medicaid agencies) and health plans. Such measures also can contribute to quality improvement. Ideally, the effort would use measures and methods widely recognized in the managed care industry, logically the Health Plan Employer Data and Information Set (HEDIS). This article summarizes a feasibility study of applying HEDIS clinical measures to CHCs as providers. It finds that, with concerted, well-directed efforts, it will be possible to use clinical HEDIS measures in health centers.     

The women's movement and older women's health: issues and policy implications

Since women are an increasing proportion of the older population, the health issues that affect older Americans must be regarded in large part as women's issues. Women experience aging differently from men. The advantage in life expectancy of women over men is not always a boon. Older women have substantially lower incomes and higher poverty rates, are more likely to be widowed and living alone, and depend more on entitlement and social service programs. This paper traces the evolution of the women's movement and identifies some of the health care problems of older women in terms of psychological, socio-cultural, and economic factors. The role of the medical establishment and federal regulations that affect older women are examined. The White House Conference on Aging (1981) is seen as a prelude to the current policies of the Administration that affect older women. Necessary policy changes on the Federal and local levels are discussed as well as the need for redirection in the women's health movement.     

How patients' sociodemographic characteristics affect comparisons of competing health plans in California on HEDIS quality measures.

OBJECTIVE: To estimate effects of patient sociodemographic characteristics on differential performance within and between plans in a single market area on the HEDIS quality of care measures, widely used for purchasing and accreditation decisions in the United States. DESIGN: Using logistic regression, we modeled associations of age, sex, and zip-code-linked sociodemographic characteristics of health plan members with HEDIS measures of screening and preventive services. We calculated the impact of adjusting for these associations on measures of health plan performance. SETTING: Twenty-two California health plans provided individual-level HEDIS data and zip codes of residence for up to 2 years. PARTICIPANTS: 110 541 commercially insured health plan members. MAIN OUTCOME MEASURES: Ten HEDIS quality-of-care measures. RESULTS: Performance on quality measures was negatively associated with percent receiving public assistance in the local area (seven out of 10 measures), percent Black (three measures), and percent Hispanic (four measures), and positively associated with percent college educated (six measures), and percent urban (three measures), controlling for plan, while associations with percent Asian were positive for three measures and negative for one (P < 0.05 for six associations, P < 0.01 for four, P < 0.001 for 17). Associations were consistent across plans and over time. Adjustment for these characteristics changed rates for most plans and measures by <5 percentage points. CONCLUSIONS: Adjustment for socioeconomic case mix has little impact on the measured performance of most plans in California, but substantially affects a few. The impact of case mix on indicators should be considered when making comparisons of health plan quality.     

Teaching and research on women's health issues in Schools of Public Health.

Women have been among the students and the faculty in Schools of Public Health since the early days of academic programs in public health. This report provides data on the recent past and current proportions of students and faculty who are women, and on the current quantity and type of teaching and research on women's health issues in the 22 North American Schools of Public Health. Teaching on these subjects is more widespread than research, but one or both are found in all but three of the schools.     

Measuring quality in women's health care: issues and recent developments

This article provides a discussion of some key quality issues in women's health care and of some recent developments in quality measurement in women's health. The work of the Women's Health Measurement Advisory Panel of the National Committee for Quality Assurance is described to illustrate some challenges and avenues for development of quality measures that address key health concerns of women and reflect their perspectives. The development of quality measures in women's health is essential for quality reporting that is meaningful for women, for quality improvement efforts within health care organizations, and for research to identify the conditions that optimize quality in women's health care.