Table of Contents


Population Criteria

        • "Encounter with Upper Respiratory Infection" EncounterWithURI
            with ["Patient Characteristic Birthdate": "Birth date"] BirthDate
              such that Global."CalendarAgeInMonthsAt" ( BirthDate.birthDatetime, start of "Measurement Period" ) >= 3
            return EncounterWithURI.QualifyingEncounter
         
        • "Initial Population"
         
        • "In Hospice"
            union "Encounter with Upper Respiratory Infection and Antibiotics Active 30 Days Prior"
            union "Encounter with Competing Diagnosis for Upper Respiratory Infection"
            union "Encounter with Comorbid Condition for Upper Respiratory Infection Prior"
         
        • "Encounter with Upper Respiratory Infection" EncounterWithURI
            without ["Medication, Order": "Antibiotic Medications for Pharyngitis"] OrderedAntibiotic
              such that OrderedAntibiotic.authorDatetime 3 days or less on or after start of EncounterWithURI.QualifyingEncounter.relevantPeriod
            return EncounterWithURI.QualifyingEncounter
         
        • None
         
        • None
         
        • "Encounter with Upper Respiratory Infection" EncounterWithURI
            with ["Patient Characteristic Birthdate": "Birth date"] BirthDate
              such that Global."CalendarAgeInMonthsAt" ( BirthDate.birthDatetime, start of "Measurement Period" ) >= 3
                and Global."CalendarAgeInYearsAt" ( BirthDate.birthDatetime, start of "Measurement Period" ) <= 17
            return EncounterWithURI.QualifyingEncounter
         
        • "Encounter with Upper Respiratory Infection" EncounterWithURI
            with ["Patient Characteristic Birthdate": "Birth date"] BirthDate
              such that Global."CalendarAgeInYearsAt" ( BirthDate.birthDatetime, start of "Measurement Period" ) in Interval[18, 64]
            return EncounterWithURI.QualifyingEncounter
         
        • "Encounter with Upper Respiratory Infection" EncounterWithURI
            with ["Patient Characteristic Birthdate": "Birth date"] BirthDate
              such that Global."CalendarAgeInYearsAt" ( BirthDate.birthDatetime, start of "Measurement Period" ) >= 65
            return EncounterWithURI.QualifyingEncounter
         
  • Definitions

    Functions

    Terminology

    • code "Birth date" ("LOINC Code (21112-8)")
    • code "Discharge to healthcare facility for hospice care (procedure)" ("SNOMEDCT Code (428371000124100)")
    • code "Discharge to home for hospice care (procedure)" ("SNOMEDCT Code (428361000124107)")
    • valueset "Antibiotic Medications for Pharyngitis" (2.16.840.1.113883.3.464.1003.196.12.1001)
    • valueset "Comorbid Conditions for Respiratory Conditions" (2.16.840.1.113883.3.464.1003.102.12.1025)
    • valueset "Competing Conditions for Respiratory Conditions" (2.16.840.1.113883.3.464.1003.102.12.1017)
    • valueset "Emergency Department Visit" (2.16.840.1.113883.3.464.1003.101.12.1010)
    • valueset "Encounter Inpatient" (2.16.840.1.113883.3.666.5.307)
    • valueset "Ethnicity" (2.16.840.1.114222.4.11.837)
    • valueset "Hospice care ambulatory" (2.16.840.1.113762.1.4.1108.15)
    • valueset "Hospital Observation Care - Initial" (2.16.840.1.113883.3.464.1003.101.12.1002)
    • valueset "Office Visit" (2.16.840.1.113883.3.464.1003.101.12.1001)
    • valueset "ONC Administrative Sex" (2.16.840.1.113762.1.4.1)
    • valueset "Payer" (2.16.840.1.114222.4.11.3591)
    • valueset "Preventive Care Services - Established Office Visit, 18 and Up" (2.16.840.1.113883.3.464.1003.101.12.1025)
    • valueset "Preventive Care Services, Initial Office Visit, 0 to 17" (2.16.840.1.113883.3.464.1003.101.12.1022)
    • valueset "Preventive Care Services-Initial Office Visit, 18 and Up" (2.16.840.1.113883.3.464.1003.101.12.1023)
    • valueset "Preventive Care, Established Office Visit, 0 to 17" (2.16.840.1.113883.3.464.1003.101.12.1024)
    • valueset "Race" (2.16.840.1.114222.4.11.836)
    • valueset "Telephone Visits" (2.16.840.1.113883.3.464.1003.101.12.1080)
    • valueset "Upper Respiratory Infection" (2.16.840.1.113883.3.464.1003.102.12.1022)

    Data Criteria (QDM Data Elements)

    • "Diagnosis: Comorbid Conditions for Respiratory Conditions" using "Comorbid Conditions for Respiratory Conditions (2.16.840.1.113883.3.464.1003.102.12.1025)"
    • "Diagnosis: Competing Conditions for Respiratory Conditions" using "Competing Conditions for Respiratory Conditions (2.16.840.1.113883.3.464.1003.102.12.1017)"
    • "Diagnosis: Upper Respiratory Infection" using "Upper Respiratory Infection (2.16.840.1.113883.3.464.1003.102.12.1022)"
    • "Encounter, Performed: Emergency Department Visit" using "Emergency Department Visit (2.16.840.1.113883.3.464.1003.101.12.1010)"
    • "Encounter, Performed: Encounter Inpatient" using "Encounter Inpatient (2.16.840.1.113883.3.666.5.307)"
    • "Encounter, Performed: Hospital Observation Care - Initial" using "Hospital Observation Care - Initial (2.16.840.1.113883.3.464.1003.101.12.1002)"
    • "Encounter, Performed: Office Visit" using "Office Visit (2.16.840.1.113883.3.464.1003.101.12.1001)"
    • "Encounter, Performed: Preventive Care Services - Established Office Visit, 18 and Up" using "Preventive Care Services - Established Office Visit, 18 and Up (2.16.840.1.113883.3.464.1003.101.12.1025)"
    • "Encounter, Performed: Preventive Care Services, Initial Office Visit, 0 to 17" using "Preventive Care Services, Initial Office Visit, 0 to 17 (2.16.840.1.113883.3.464.1003.101.12.1022)"
    • "Encounter, Performed: Preventive Care Services-Initial Office Visit, 18 and Up" using "Preventive Care Services-Initial Office Visit, 18 and Up (2.16.840.1.113883.3.464.1003.101.12.1023)"
    • "Encounter, Performed: Preventive Care, Established Office Visit, 0 to 17" using "Preventive Care, Established Office Visit, 0 to 17 (2.16.840.1.113883.3.464.1003.101.12.1024)"
    • "Encounter, Performed: Telephone Visits" using "Telephone Visits (2.16.840.1.113883.3.464.1003.101.12.1080)"
    • "Intervention, Order: Hospice care ambulatory" using "Hospice care ambulatory (2.16.840.1.113762.1.4.1108.15)"
    • "Intervention, Performed: Hospice care ambulatory" using "Hospice care ambulatory (2.16.840.1.113762.1.4.1108.15)"
    • "Medication, Active: Antibiotic Medications for Pharyngitis" using "Antibiotic Medications for Pharyngitis (2.16.840.1.113883.3.464.1003.196.12.1001)"
    • "Medication, Order: Antibiotic Medications for Pharyngitis" using "Antibiotic Medications for Pharyngitis (2.16.840.1.113883.3.464.1003.196.12.1001)"
    • "Patient Characteristic Birthdate: Birth date" using "Birth date (LOINC Code 21112-8)"
    • "Patient Characteristic Ethnicity: Ethnicity" using "Ethnicity (2.16.840.1.114222.4.11.837)"
    • "Patient Characteristic Payer: Payer" using "Payer (2.16.840.1.114222.4.11.3591)"
    • "Patient Characteristic Race: Race" using "Race (2.16.840.1.114222.4.11.836)"
    • "Patient Characteristic Sex: ONC Administrative Sex" using "ONC Administrative Sex (2.16.840.1.113762.1.4.1)"

    Supplemental Data Elements

    Risk Adjustment Variables