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The Opportunity
While many infectious diseases have been controlled or eradicated through the use of vaccines and advanced medicine, infectious disease continues to cause widespread morbidity and mortality, and rising health care costs. Specifically:
- In 2008, hospital charges for infectious disease averaged $96 billion per year with an average 4.5 million hospital days per year.1
- An estimated 1.2 million Americans are living with HIV/AIDS, and nearly 642,000 Americans have died from AIDS since 1981. 2 Last year total federal spending on HIV/AIDS-related medical care, research, prevention, and other activities was $21.3 billion. For fiscal year 2013, President Obama has requested $22.4 billion to combat HIV in the U.S.3
- According to the Centers for Disease Control and Prevention (CDC), every year the healthcare system spends $17 billion on sexually transmitted infections.4 It is estimated that in the U.S. there are roughly 19 million new infections every year.5
Providing resources, such as patient education and intervention programs along with continued scientific research for existing and emerging diseases, will reduce mortality and healthcare costs. Appropriate use of antibiotics and antibiotic stewardship are critical factors in management of infectious disease. Antibiotic stewardship provides an opportunity to not only shorten an individual's length-of-stay in the hospital and improve patient outcomes, but also has the potential to reduce healthcare costs.6 A University of Maryland study indicated that over 8 years, an antibiotic stewardship program saved $17 million.7
NQF has endorsed a number of consensus standards to evaluate the quality of care for topic areas related to infectious disease over the past decade. As quality measurement has matured, better data systems have become available, electronic health records are closer to widespread adoption, and the demand for meaningful performance measures has prompted development of more sophisticated measures of healthcare processes and outcomes for infectious disease conditions. An evaluation of the NQF-endorsed® infectious disease measures and consideration of new measures will ensure the currency of NQF's portfolio of voluntary consensus standards.
About the Project
This project began in April 2012.
Objectives
To ensure the currency of NQF's portfolio of voluntary consensus standards for infectious disease, both newly submitted measures and consensus standards for maintenance review will undergo the consensus development process together, including review against the most recent NQF evaluation criteria. In addition to ensuring currency of specifications and evidence for the focus of the measure, endorsement maintenance provides the opportunity to harmonize specifications and to ensure that an endorsed measure represents the "best in class."
NQF is seeking performance measures that can be used for accountability and public reporting in the following topic areas related to infectious disease (viral, bacterial, fungal, or parasitic infections) for adults and children in all settings of care. Measures addressing screening, vaccinations, treatments, diagnostic studies, interventions, or procedures associated with infectious diseases including but not limited to:
- HIV/AIDS;
- Hepatitis;
- Respiratory infections including URI, acute bronchitis, influenza, tuberculosis and other respiratory infections (except pneumonia*);
- Infections of the various organ systems including neurologic, musculoskeletal, gastrointestinal, genitourinary or skin and soft tissues;
- Sexually transmitted infections;
- Opportunistic and atypical infections;
- Sepsis and septic shock;
- Adult immunizations (except influenza and pneumococcal**); and
- Infectious disease threats: bioterrorism, pandemics and emerging infections.
*Measures for pneumonia are being considered in the Pulmonary and Critical Care project.
**Measures for influenza and pneumococcal immunization have recently been considered in the Population Health project: Phase 1.
NQF is also soliciting performance measures related to antimicrobial use including appropriate care, antimicrobial stewardship and management of antimicrobial resistance such as MRSA.
NQF Process
The candidate measures will be considered for NQF endorsement as voluntary consensus standards. Agreement around the recommendations will be developed through NQF's formal Consensus Development Process (CDP, Version 1.9). This project will involve the active participation of representatives from across the spectrum of healthcare stakeholders and will be guided by a multiple-stakeholder Steering Committee.
Funding
This project is supported under a contract provided by the Department of Health and Human Services.
Related NQF Work
Contact Information
For further information, contact Reva Winkler, MD, MPH, or Adeela Khan, Project Analyst, at 202-783-1300 or via email at infectiousdisease@qualityforum.org.
- Christensen KL, Holman RC, Steiner CA, et al. Infectious disease hospitalizations in the United States. Clin Infect Dis, 2009;49(7):1025-1035.
- The Henry J. Kaiser Family Foundation (KFF). HIV/AIDS Policy Fact Sheet. The HIV/AIDS Epidemic in the United States. Menlo Park, CA:KFF March 2012. Available at www.kff.org/hivaids/upload/3029-13.pdf. Last accessed March 2012.
- KFF. HIV/AIDS Policy Fact Sheet. U.S. Federal Funding for HIV/AIDS: The President’s FY 2013 Budget Request. Menlo Park, CA:KFF, February 2012. Available at www.kff.org/hivaids/upload/7029-08.pdf. Last accessed March 2012.
- Centers for Disease Control and Prevention (CDC). Sexually Transmitted Disease Surveillance, 2010. Atlanta, GA:CDC, 2011. Available at www.cdc.gov/std/stats10/trends.htm. Last accessed March 2012.
- Ibid.
- CDC. Antibiotic stewardship — the ultimate return on investment. Atlanta, GA:CDC, 2011. Available at www.cdc.gov/getsmart/healthcare/learn-from-others/factsheets/antibiotic-use.html. Last accessed March 2012.
- Ibid.
