Choosing Chronic Disease Measures for Hedis

Conceptual Framework and Review of Several Clinical Ideas

Published in: Managed Care Quarterly, v. 4, No. 3, 1996, p. 54-77

Posted on RAND.org on December 31, 1995

by Elizabeth A. McGlynn

Few quality measures are available today that assess care for chronic conditions. The current Health Plan Employer Data and Information Set (HEDIS) may not capture the critical dimensions of quality for chronic diseases. This article proposes five criteria for selecting diseases for quality assessment: prevalence or effect on mortality and morbidity, efficacy of treatment, potential for improving quality, reasonable cost, and whether recommended interventions are under the plan's control. The author reviews the literature on the effectiveness of interventions for seven diseases, and recommends possible areas for the development of quality measures.

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