HAB Performance Measures Group 2 -
Hepatitis C Screening
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Performance Measure: Hepatitis C Screening -
OPR-Related Measure: Yes TOP |
Percentage of clients for whom Hepatitis C (HCV) screening was performed at least once since the diagnosis of HIV infection.
Number of HIV-infected clients who have documented HCV status in chart [ 1 ]
Number of HIV-infected clients who had a medical visit with a provider with prescribing privileges [ 2 ] at least once in the measurement year
None
- Is the client HIV-infected? (Y/N)
- If yes, is there documentation of the client's Hepatitis C status in the medical record? (Y/N)
- Ryan White Program Data Report, Section 5, Items 42 and 48 may provide data useful in establishing a baseline for this performance measure
- Electronic Medical Record/Electronic Health Record
- CAREWare, Lab Tracker, or other electronic data base
- HIVQUAL reports on this measure for grantee under review
- Medical record data abstraction by grantee of a sample of records
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| National Goals, Targets, or Benchmarks for Comparison TOP |
IHI Goal: 95% [ 3 ]
National HIVQUAL Data [ 4 ]
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2003 |
2004 |
2005 |
2006 |
| Top 10% |
100.0% |
100.0% |
100.0% |
100.0% |
| Top 25% |
99.4% |
100.0% |
100.0% |
100.0% |
| Mean* |
86.2% |
88.8% |
90.5% |
90.9% |
*from HAB data base
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| Outcome Measures for Consideration TOP |
- Hepatitis C- related mortality rates in the clinic population
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| Basis for Selection and Placement in Group 2 TOP |
Chronic hepatitis C infection is common in persons with HIV infection, and although it is a source of substantial morbidity and mortality, it may be amenable to treatment. HIV/ hepatitis C co-infection may predispose HIV-infected patients to liver toxicity from HAART [ 5 ] and HCV treatment may exacerbate the side effects of some ARV medications. [ 6 ]
Measure reflects important aspect of care that impacts HIV-related morbidity and focuses on treatment decisions that affect a sizable population. Measure has a strong evidence base supporting the use.
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| US Public Health Service Guidelines TOP |
"All HIV-infected patients should be screened for HCV infection" [ 7 ] (6/14/02) .
[1] Unless there is concern about ongoing exposure (e.g., via active injection drug use), annual re-screening is not generally recommended.
[2] A "provider with prescribing privileges" is a health care professional who is certified in their jurisdiction to prescribe ARV therapy.
[3] IHI Measure reads, " Percent of Patients/Clients with Known Hepatitis C Status"
( http://www.ihi.org/IHI/Topics/HIVAIDS/HIVDiseaseGeneral/Measures/PercentofPatientsClientswith
KnownHepatitisCStatus.htm )
[4] ( http://www.hivguidelines.org/admin/files/qoc/hivqual/proj%20info/HQNatlAggScrs3Yrs.pdf )
[5] AIDS Institute, New York State Department of Health. Criteria for the Medical Care of Adults with HIV Infection, Hepatitis C Virus Updated September 2004 [Text taken from the NYSDOH AI publication - "Criteria for the Medical Care of Adults with HIV Infection"] ( http://www.hivguidelines.org/public_html/hep-c/hepc.pdf )
[6] Guidelines for the Use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents
( http://aidsinfo.nih.gov/ContentFiles/AdultandAdolescentGL.pdf )
[7] Centers for Disease Control and Prevention. Guidelines for Preventing Opportunistic Infections Among HIV-Infected Persons - 2002 Recommendations of the U.S. Public Health Service and the Infectious Diseases Society of America . MMWR 2002;51(No. RR-8) ( http://www.cdc.gov/mmwr/PDF/rr/rr5108.pdf or http://aidsinfo.nih.gov/ContentFiles/OIpreventionGL.pdf ) .
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