measures
- Joseph Gulotta
- Joe Tronco
- Alex Laird (Unlicensed)
- Jaz-Michael King (Unlicensed)
Summary
The measures table (pellucid.measures) stores the specifications for the various measures for which Pellucid captures data values. These include indicators of cost, quality and experience used to measure the numeric values found in the 'entity_values' table. The measures table primary key is the measures.measure_id; the measures.author_id is a foreign key which links the measure to the 'measure_authors' table.
Measures may appear to be duplicated where there are two sources for the same measure data, or where measures have been versioned. In each case, a new measures.measure_id is created. For examples SCIP measures are captured from national CMS data but also captured from local sources that are one quarter more current. The measures are exactly the same, but the collection process differs as does the reporting period, therefore a new measure is created.
Measures is not restricted to traditional quality measures. For example, in Pellucid "bed count" is a measure. Measures are classified into measure domains.
Measures that are replaced by newer versions, such as PN-5, PN-5a and PN-5b. While these measures could be grouped under "timely antibiotic" and displayed as one continuous measure, Pellucid considers them three distinct measures; grouping or contiguity must be performed at the local application level after retrieval from Pellucid.
For information on groups of measures and specific measure data as they are reported, please see Measures Catalog
Fields
| field | type | attributes | notes | example |
|---|---|---|---|---|
| measures.measure_id | int(11) | NOT NULL AUTO_INCREMENT | provided by Pellucid | 123456 |
| measures.author_id | int(11) | DEFAULT NULL | Foreign key from measure_authors | 123456 |
| measures.parent_id | int(11) | DEFAULT NULL | Reserved for future relationship mapping | 123456 |
| measures.name_friendly | text | DEFAULT NULL | Consumer-friendly name of the measure | Collapsed Lung caused by Medical Care |
| measures.name_official | text | DEFAULT NULL | The author's name for the measure | Iatrogenic Pneumothorax |
| measures.name_internal | text | DEFAULT NULL | Pellucid's internal name, often the exact same as name_official. Used primarily for disambiguation where measures share an official name or are overly similar or use varying units of measurement. | Iatrogenic Pneumothorax (Ratio) |
| measures.description_friendly | text | DEFAULT NULL | Friendly description of what this measure measures. | This measure compares the observed number of collapsed lung caused by medical care per 1,000 patients with the statistically expected number of collapsed lung caused by medical care. The value displayed is a ratio of observed to expected. |
| measures.description_long | text | DEFAULT NULL | Official measure description from the author. | Iatrogenic pneumothorax cases (secondary diagnosis) per 1,000 surgical and medical discharges for patients ages 18 years and older. Excludes cases with chest trauma, pleural effusion, thoracic surgery, lung or pleural biopsy, diaphragmatic surgery repair, or cardiac procedures; cases with a principal diagnosis of iatrogenic pneumothorax; cases with a secondary diagnosis of iatrogenic pneumothorax present on admission; and obstetric cases. |
| measures.author_measure_id | text | DEFAULT NULL | If the author uses unique measure ids, capture it here. | PSI 06 |
| measures.author_measure_specs | text | DEFAULT NULL | Local or remote file reference to the measure specifications for this measure. | http://www.qualityindicators.ahrq.gov/Modules/PSI_TechSpec.aspx |
| measures.rationale_long | text | DEFAULT NULL | Usually gleaned from the measure spec, this rationale is intended for researchers and clinicians. | Widespread consensus exists that health care organizations can reduce patient injuries by improving the environment for safety from implementing technical changes, such as electronic medical record systems, to improving staff awareness of patient safety risks. Clinical process interventions also have strong evidence for reducing the risk of adverse events related to a patient’s exposure to hospital care. Patient Safety Indicators (PSIs), which are based on computerized hospital discharge abstracts from the AHRQ’s Healthcare Cost and Utilization Project (HCUP), can be used to better prioritize and evaluate local and national initiatives. Analyses of these and similar inexpensive, readily available administrative data sets may provide a screen for potential medical errors and a method for monitoring trends over time. The iatrogenic pneumothorax indicator is intended to flag cases of pneumothorax caused by medical care. Iatrogenic pneumothorax excludes all trauma patients because these patients may be more susceptible to nonpreventable iatrogenic pneumothorax or may be miscoded for traumatic pneumothorax. |
| measures.rationale_friendly | text | DEFAULT NULL | A consumer-friendly rationale for improving and/or reporting the measure. | When hospitals follow proven guidelines, patients get better and safer care and, in this case, that can mean fewer people die from their heart attacks. |
| measures.evidence | enum('more is better','less is better','no evidence','no difference','within_range_is_better') | NOT NULL DEFAULT 'no evidence' | For every measure Pellucid knows if there is literature-based evidence that moving the numbers for this measure in either direction is favourable, or if the evidence has shown the measure to be inconsequential.
| less is better |
| measures.sig_var_test | VARCHAR(64) | DEFAULT NULL | Tracks the type of significance test applied to this measure | IQR |
| measures.measure_type | enum('process','outcome','access','experience', 'utilization','structure','population') | DEFAULT NULL | Defines the kind of measure used. Corresponds to the NQMC measure domains. | outcome |
| measures.default_unit | enum('percent','per 1000','per 'dollars','na','minutes','people','square miles','years','households','per 100','per 10000','micrograms') | DEFAULT 'percent' | Denotes the standard unit for the measure | ratio |
| measures.measure_incept_date | date | NOT NULL DEFAULT '0000-00-00' | When this measure was conceived or first used in the wild. In most instances this date will represent the earliest data available in Values for this measure. | 2004-04-01 |
| measures.measure_expiry_date | date | NOT NULL DEFAULT '0000-00-00' | When this measure was retired or otherwise expired by the author. All zeroes signals no expiration. | 0000-00-00 |
| measures.nqf_endorsed | enum('0','1','2') | NOT NULL DEFAULT '0' |
| 1 |
| measures.nqf_endorsed_date | date | NOT NULL DEFAULT '0000-00-00' |
| 2003-09-01 |
| measures.numerator_definition | text | DEFAULT NULL | Primarily intended for contextual Web tooltip content, this definition clarifies the numerator. | Discharges with ICD-9-CM code for iatrogenic pneumothorax in any secondary diagnosis field among cases meeting the inclusion and exclusion rules for the denominator. (see measure specifications) |
| measures.denominator_definition | text | DEFAULT NULL | Primarily intended for contextual Web tooltip content, this definition clarifies the denominator. | All surgical and medical discharges, age 18 years and older, defined by specific DRGs or MS-DRGs. Exclude cases: with principal diagnosis of iatrogenic pneumothorax or secondary diagnosis present on admission; MDC 14 (pregnancy, childbirth, puerperium); with any diagnosis code of chest trauma or pleural effusion; with a code of diaphragmatic surgery repair in any procedure field; with any code indicating thoracic surgery, lung or pleural biopsy, or cardiac surgery |
| measures.minimum_sample | int(11) | DEFAULT NULL | minimum sample for default analysis/interpretation of values | 30 |
| measures.created | timestamp | NOT NULL DEFAULT '0000-00-00 00:00:00' | Date of INSERT into Pellucid | 2009-10-11 12:42:23 |
| measures.modified | timestamp | NOT NULL DEFAULT '0000-00-00 00:00:00' ON UPDATE CURRENT_TIMESTAMP | Date of most recent UPDATE into Pellucid | 2010-02-12 23:42:45 |
Table Creation
CREATE TABLE IF NOT EXISTS `measures` (
`measure_id` int(11) NOT NULL AUTO_INCREMENT,
`author_id` int(11) DEFAULT NULL,
`parent_id` int(11) DEFAULT NULL,
`name_friendly` text DEFAULT NULL,
`name_official` text DEFAULT NULL,
`name_internal` text DEFAULT NULL,
`description_friendly` text DEFAULT NULL,
`description_long` text DEFAULT NULL,
`author_measure_id` text DEFAULT NULL,
`author_measure_specs` text DEFAULT NULL,
`rationale_long` text DEFAULT NULL,
`rationale_friendly` text DEFAULT NULL,
`evidence` enum('more_is_better','less_is_better','no_evidence','no_difference','within_range_is_better') NOT NULL DEFAULT 'more_is_better',
`sig_var_test` VARCHAR(64) DEFAULT NULL,
`measure_type` enum('process','outcome','access','experience','utilization','structure','population') DEFAULT NULL,
`default_unit` enum('percent','per 1000','per 100000','cases','ratio','days','hours','patients','dollars','na','minutes','people','square miles','years','households','per 100','per 10000','micrograms') DEFAULT 'percent',
`measure_incept_date` date NOT NULL DEFAULT '0000-00-00',
`measure_expiry_date` date NOT NULL DEFAULT '0000-00-00',
`nqf_endorsed` enum('0','1','2') NOT NULL DEFAULT '0',
`nqf_endorsed_date` date NOT NULL DEFAULT '0000-00-00',
`numerator_definition` text DEFAULT NULL,
`denominator_definition` text DEFAULT NULL,
`minimum_sample` int(11) DEFAULT NULL,
`created` timestamp NOT NULL DEFAULT '0000-00-00 00:00:00',
`modified` timestamp NOT NULL DEFAULT '0000-00-00 00:00:00' ON UPDATE CURRENT_TIMESTAMP,
PRIMARY KEY (`measure_id`)
) ENGINE=InnoDB DEFAULT CHARSET=utf8 AUTO_INCREMENT=17109 ;