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Reporting Quality for GPRA

Differences between the Transparency and GPRA Measures
IHS, along with other Federal health care agencies such as the Veterans Administration (VA) and the Department of Defense (DoD), is required to report on the quality of care it provides to its patients. This is known is “Transparency.” This requirement is from a 2006 Executive Order from President Bush. To meet this requirement, IHS reports seven performance measures. These performance measures are called “Transparency” measures”. The VA and the DoD are also reporting some of the Transparency measures.

The IHS Transparency measures were developed by IHS and are to be reported by all Federal IHS health care facilities so that patients and the general public can compare performance on the measures between IHS facilities.

The Government Performance and Results Act (GPRA) measures are developed by each Agency as a way for each Agency and Congress to look at their performance. Each Agency sets its own priorities and goals for improving performance. The GPRA measures were devised by subject matter experts within IHS and are specific to the types of health issues that affect the patients of IHS. IHS has been reporting many of the GPRA measures since 2002, whereas the Transparency measures are being reported beginning in 2008.

You will see there are some differences between the Transparency and GPRA measures. In most cases, this is because IHS has set a more difficult goal for itself because of the great importance of these health problems to the AI/AN people.

Listed below is a comparison of the Transparency and GPRA measures.

Comparison Measure Transparency GPRA
Diabetes Blood Sugar Control Diabetic patient has a blood sugar with a result that is greater than 9 OR patient has no blood sugar test OR patient has blood test but it does not have a result Diabetic patient has a blood sugar test with a result that is greater than 9.5
Diabetes Blood Pressure Control Diabetic patient has blood pressure less than 140/90 Diabetic patient has blood pressure less than 130/80
Diabetes LDL Cholesterol Diabetic patient has an LDL cholesterol test with a result less than 100 Diabetic patient has an LDL cholesterol test
Immunizations Flu Shot Patients ages 50-64 who receive a flu shot once each year Patients 65 and older receive a flu shot once each year
Asthma Appropriate Medication Asthma patients 5-56 who receive appropriate asthma medication therapy No GPRA measure
Pneumonia Oxygen Assessment Pneumonia patients 18 and older diagnosed with pneumonia had their oxygen saturation level assessed No GPRA measure
Ischemic Stroke with Atrial Fibrillation Anticoagulant Therapy Stroke patients with irregular heart rhythm ages 18 and older who receive anticoagulant therapy (blood thinners) No GPRA measure

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