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CAT QAIHC Indicator Quick Reference Guide 3.4

 

Introduction

The Queensland Aboriginal and Islander Health Council (QAIHC) have developed a set of core indicators, funded through the Health Information Project, designed to support quality improvement initiatives. A subset of these indicators is provided in the CAT QAIHC Indicators report.

The CAT HFL Indicators module is available for clinical systems where the CAT data extract meets the CAT data specifications version 1_6 or higher.

MBS Item Indicators in the report (indicators 10, 12, 14 and 20) are available where the clinical and billing systems are provided by the same vendor.

About this Guide

This guide provides a description of each indicator in the report. The 'CAT User Guide Appendices Data Mappings' provides an explanation of where most of the data items are collected from in each clinical system. This guide provides any additional explanations required and details of any calculations used.

Notes:
1) Indicators report data for Recent Attenders, Active and Recent Attendees, and All Patients From June 2012 MD and BP users are able to extract archived and deceased patients that have had a visit in the last 2 years. Refer to "Extracting Additional Patients Quick Reference Guide". If the practice has elected to include archived patients then these will be included in the above populations provided they still meet the visit criteria. Hence the patient totals will vary depending on your preference selection.

Recent attenders are patients that have had a visit in the last 6 months.
Active attenders are patients that have had 3 visits in the last 2 years.
From June 2012: All Patients is restricted to patients that have had a visit in the last 2 years.
2) Visit Definition - check the Clinical Audit Tool User Guide Mappings Appendix for your clinical system.
3) In this report a child is 0-14 years and an adult >=15 years.
4) To maximise your service's performance, all clinical staff or clinical service providers should have their own log ins for the clinical system and make a record of client or patient visits or consultations in progress notes and other parts of the clinical record as appropriate.

QAIHC Report

The Report is available under Standard Reports > Indicator Sets

Indicator Descriptions

 

Patient Demographics

The number of patients seen in the last 6 months

  • Total
  • Breakdown by adults and children

1. Service Contacts

The number of service contacts in the last 6 months

  • Total
  • Breakdown by the provider who has recorded the visit

6. Smoking

This indicator provides the Adult smoking status breakdown.

7. Alcohol

This indicator provides the Adult alcohol consumption status breakdown.
A drinker is at risk if they

  • drink > 2 drinks on a regular occasion
  • binge drink (MD only which is currently recorded as >= 6 drinks on any occasion)

    A drinker is low risk if they drink but do not meet the at risk criteria

8. Obesity and Overweight Prevalence

a) Waist
b) BMI

This indicator looks at Adult measurements taken in the last 12 months.
It provides the breakdown of waist and bmi measurements by gender.

9. Physical Activity

This indicator looks at Adult physical activity assessment recorded in the last 2 years. A patient meets the physical activity guidelines if they are assessed with a moderate/high level of activity.

Medical Director:
In MD a physical activity assessment is done by clicking on the 'running man' icon or choosing 'Assessment > Physical Activity' from the menu. A physical activity assessment is deemed as done if either an assessment or a prescription is recorded.
Where an assessment has been done, if the score is > 5 the patient meets the physical activity guidelines, otherwise they do not meet the guidelines.

Best Practice:
In BP a physical activity prescription is done by selecting the 'Clinical > Physical Activity Prescription' menu option. The prescription must be printed for it to be saved.
A selected 'current physical activity level' of moderate or active meets the physical activity guidelines, otherwise they do not meet the guidelines

10. Adult Health Checks (Pre May 10: MBS 704,706,710; Post May 10: MBS 715)

Adult patients who have had an adult health check done in the last 2 years

  • 15-54 years
  • >= 55 years


    Note: MBS Item Indicators in the report are available where the clinical and billing systems are provided by the same vendor.

11. Diabetic Client Coverage

The number of Adult patients with a diagnosis of Diabetes.
This is compared with the expected % of 15%.

12. Diabetic Patients on GPMP (MBS 721)

The number of Adult Diabetic Type II patients who have had a GP Management Plan done in the last 12 months.

Note: MBS Item Indicators in the report are available where the clinical and billing systems are provided by the same vendor.

13. Diabetes HbA1c Recorded

The number of Adult Diabetic Type II patients who have had an HbA1c recorded in the last 12 months.

14. CHD Patients on GPMP (MBS 721)

The number of Adult CHD patients who have had a GP Management Plan done in the last 12 months.

Note: MBS Item Indicators in the report are available where the clinical and billing systems are provided by the same vendor.

15. Hypertension Prevalence and Screening

a) BP < 12 mths
b) Patients with Hypertension
c) Patients with Hypertension and BP < 6mths

The risk of cardiovascular diseases increases as BP increases. These indicators look at the level of BP recording in the Adult patient population and the Adult patient population with Hypertension.
a) The number of adult patients in the population who have had a BP recorded in the last 12 months
b) The number of adult patients with a diagnosis of Hypertension
This is compared with an expected % of 10%.
c) The of adult patients with a diagnosis of Hypertension who have had a BP recorded in the last 6 months

16. Hypertension on correct Medication

The number of Adult Hypertension patients currently on an ACE or A2 medication.

17. Antenatal Care Coverage

The Proportion of Indigenous women who gave birth in the last 6 months who attended antenatal care.

Refer to the tables at the end of this guide for data item explanations.
Count Date of birth <= 6mths
Antenatal pane with any visit for this pregnancy is an antennal attendance

18. Timely Antenatal Care

The Proportion of Indigenous women who gave birth in the last 6 months who attended their first antenatal care visit

  • < 13 wks
  • 13wks – <20 wks
  • >=20 wks
  • Not recorded


    Refer to the tables at the end of this guide for data item explanations.
    Count Date of birth <= 6mths
    Antenatal pane with any visit for this pregnancy is an antennal attendance

    Antenatal visit date for this pregnancy is compared to the gestation to determine the number of weeks where the first visit falls.

19. Low and High Birth weight Babies

The Proportion of babies born to Indigenous women* whose weight was

  • < 2500 grams
  • 2500 – 4499 grams
  • >= 4500 grams


    Refer to the tables at the end of this guide for data item explanations.
    Count Date of birth <= 6mths

    * includes live births only, excludes births <= 20 weeks gestation

20. Indigenous Child Health Checks (Pre May 10: MBS 708; Post May 10: MBS 715)

Indigenous children who have had a child health check done in the last 2 years

  • <=5 years
  • >5 and < 15 years


    Note: MBS Item Indicators in the report are available where the clinical and billing systems are provided by the same vendor.

21. Under and Overweight Children

a) < 5years
b) 5-14 years

This indicator looks at childrens measurements taken in the last 6 months.
a) Children < 5 yrs – weight and height
b) Children >=5, < 15 - bmi

The indicator compares the measurements against the 5th and 95th percentile of the WHO growth charts. These are available at http://www.who.int/childgrowth/standards/en/index.html

26. Adequate Antenatal Care

The Proportion of Indigenous women who gave birth in the last 6 months who attended antenatal care

  • >= 4 visits
  • <= 3 visits
  • No visit recorded


    Refer to the tables at the end of this guide for data item explanations.
    Count Date of birth <= 6mths
    Antenatal pane with any visit for this pregnancy is an antennal attendance

27. Proportion of Preterm Births

The Proportion of Indigenous women who gave birth in the last 6 months* who were <= 36 weeks gestation.

Refer to the tables at the end of this guide for data item explanations.
Count Date of birth <= 6mths

* includes live births only, excludes births <= 20 weeks gestation

28. Risk of Renal Disease

This indicator provides a breakdown of Adults patients who have had a creatinine or ACR measurement recorded in the last 6 months.

a)-c) eGFR
Creatinine is used to calculate the eGFR using the revised MDRD formula:


Patients are reported for:

  • eGFR > 90mls/min
  • eGRR <= 90mls/min, >= 60mls/min
  • eGR < 60 mls/min


    d) ACR
    ACR (mg/mmol) = microalbumin (mg/L) / urinary creatinine (mmol/L)

    Refer to the 'CAT User Guide Appendices Data Mappings' for your clinical system for an explanation of how ACR, microalbumin and urinary creatinine are collected.

    Patients are reported for:
  • ACR > 3.5 mg/mmol

Further Information

Further information is available from QAIHC:
PHMO, Dr Katie Panaretto on KatiePanaretto@qaihc.com.au

Health Informatics Project Officer, Melvina Mitchell on MelvinaMitchell@qaihc.com.au

Tables

 

Table 1: Medical Director Pregnancy, Antenatal and Births

In MD, data on pregnancy, antenatal and births is collected from the Obstetric tab.
The top pane provides the list of pregnancies.
The bottom pane provides the list of antenatal visits for each pregnancy.

Data Item

User Interface

Description

 

Pregnancy Pane Columns

 

Date of birth

Date

Provides the date of birth (only counting dates <= 6mths

Gestation

Gestation

Gestation in weeks at birth
Note: if this field is 0 the gestation will be calculated as date of birth – LNMP

LMP

LNMP

Last known menstrual period

Outcome

Outcome

Live if Outcome and birth weight entered

Birth Weight

B.Weight

Birth weight in grams

 

 

 

 

Antenatal pane columns

 

Antenatal visit date

Date

Antenatal visit date for this pregnancy

Table 2: Best Practice Pregnancy, Antenatal and Births

In BP, data on pregnancy, antenatal and births is collected from the Obstetric icon in the tree view.
The top left pane provides the list of pregnancies.
The top right pane provides the baby details for each pregnancy.
The bottom pane provides the list of antenatal visits for each pregnancy.

Data Item

User Interface

Description

 

Pregnancy Pane Columns

 

Date of birth

Ended

Provides the date of birth (only counting dates <= 6mths

Gestation

Weeks

Gestation in weeks at birth
Note: if this field is 0 the gestation will be calculated as date of birth – LMP

LMP

LMP

Last known menstrual period

Outcome

Outcome

Live if 'Live birth' selected

 

 

 

 

Pregnancy Details Columns

 

Birth weight

Babies Birth Weight

Birth weight in grams

 

 

 

 

Antenatal pane columns

 

Antenatal visit date

Date

Antenatal visit date for this pregnancy

...