Prenatal Care: Screening for Human Immunodeficiency Virus (HIV) (NQF 0012)

eMeasure Name Prenatal Care: Screening for Human Immunodeficiency Virus (HIV) eMeasure Id CAF0A28E-8875-401A-B59B-95DAE1E3FA47
Version number 1 eMeasure Set Id D4D6A7A4-88F8-4D6E-AB3E-09F80C3D4EB5
Available Date No information Measurement Period January 1, 20xx through December 31, 20xx
Measure Steward American Medical Association - Physician Consortium for Performance Improvement
Endorsed by National Quality Forum
Description Percentage of patients, regardless of age, who gave birth during a 12-month period who were screened for HIV infection during the first or second prenatal visit
Copyright
© 2010 American Medical Association.  All Rights Reserved
Measure scoring Proportion
Measure type Process
Stratification
None
Risk Adjustment
None
Data Aggregation
Rationale
While the number of perinatally transmitted cases of HIV has decreased, perinatal transmission still accounts for the majority of new cases of HIV in children. 
Benefits of knowing a woman's HIV status early on in pregnancy have been well documented and allow the health care provider to initiate treatment early on in the pregnancy, thereby decreasing the risk of transmission of HIV to the child.
Clinical Recommendation Statement
Universal HIV testing with patient notification should be a routine component of prenatal care; however, this must be in accordance with current state laws (ACOG/AAP). PHS recommends that all pregnant women in the United States be tested for HIV infection. All health-care providers should recommend HIV testing to all of their pregnant patients, pointing out the substantial benefit of knowledge of HIV status for the health of women and their infants. HIV screening should be a routine part of prenatal care for all women (CDC). Clinicians should screen all pregnant women for HIV. There is good evidence that both standard and FDA-approved rapid screening tests accurately detect HIV infection in pregnant women and fair evidence that introduction of universal prenatal counseling and voluntary testing increases the proportion of HIV-infected women who are diagnosed and are treated before delivery (USPSTF) (A Recommendation).
Improvement notation
Higher score indicates better quality
Measurement duration
12 month(s)
Reference
American Academy of Pediatrics and American College of Obstetricians and Gynecologists. Guidelines for Prenatal Care, 5th Edition. Elk Grove Village, IL, AAP/ACOG, 2002.
Reference
A Brief Evidence Update for the U.S. Preventive Services Task Force. Available at: www.preventiveservices.ahrq.gov. Accessed November 2005.
Reference
US Preventive Services Task Force. Guide to Clinical Preventive Services. 3rd ed. Baltimore, Md: Williams amp; Wilkins; 2000-2002.
Reference
CDC. Revised recommendations for HIV screening of pregnant women. MMWR 2001; 50(No. RR-19). Available at: http://www.cdc.gov.mmwr/. Accessed November 2005.
Definition
Initial Patient Population(s): Diagnosis Active: Documented diagnosis of pregnancy, delivered during the measurement period. Procedure: Delivery during the measurement period.
Definition
Denominator(s): All patients, regardless of age, who gave birth during a 12-month period, seen for continuing prenatal care.
Definition
Denominator Exclusion(s): Patient has a known diagnosis of HIV.
Definition
Numerator(s): Patients who were screened for HIV infection during the first or second prenatal visit.
Definition
Denominator Exception(s): Documentation of patient reason(s) for not screening for HIV during the first or second prenatal visit (eg, patient declined).
Guidance
The unit of analysis is a pregnancy, so that for a patient with two pregnancies that each delivered during the measurement period, each pregnancy is measured. The purpose of the data element "Estimated date of conception" <= 44 weeks starts before or during "Procedure, Performed: Delivery of Live Birth" is to establish the date when the pregnancy began.  We have included the timeframe of 44 weeks prior to the delivery date to link the estimated date of conception to the delivery that occurred during the measurement period (to ensure it isn't the estimated date of conception for a previous pregnancy).
Supplemental Data Elements
Report "Patient Characteristic: Gender" using "Gender HL7 Value Set (2.16.840.1.113883.1.11.1)"; Report "Patient Characteristic: Race" using "Race CDC Value Set (2.16.840.1.114222.4.11.836)"; Report "Patient Characteristic: Ethnicity" using "Ethnicity CDC Value Set (2.16.840.1.114222.4.11.837)"; Report "Patient Characteristic: Payer" using "Payer Source of Payment Typology Value Set (2.16.840.1.113883.3.221.5)".

Table of Contents


Population criteria

Data criteria (QDM Data Elements)

Supplemental Data Elements




Measure set CLINICAL QUALITY MEASURE SET 2011-2012