| eCQM Title | Children Who Have Dental Decay or Cavities |
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|---|---|---|---|
| eCQM Identifier (Measure Authoring Tool) | 75 | eCQM Version Number | 9.2.000 |
| NQF Number | Not Applicable | GUID | 61947125-4376-4a7b-ab7a-ac2be9bd9138 |
| Measurement Period | January 1, 20XX through December 31, 20XX | ||
| Measure Steward | Centers for Medicare & Medicaid Services (CMS) | ||
| Measure Developer | National Committee for Quality Assurance | ||
| Endorsed By | None | ||
| Description |
Percentage of children, 6 months - 20 years of age, who have had tooth decay or cavities during the measurement period |
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| Copyright |
This Physician Performance Measure (Measure) and related data specifications are owned and stewarded by the Centers for Medicare & Medicaid Services (CMS). CMS contracted (Contract HHSP23320095627WC; HHSP23337008T) with the National Committee for Quality Assurance (NCQA) to develop this electronic measure. NCQA is not responsible for any use of the Measure. NCQA makes no representations, warranties, or endorsement about the quality of any organization or physician that uses or reports performance measures and NCQA has no liability to anyone who relies on such measures or specifications. Limited proprietary coding is contained in the Measure specifications for user convenience. Users of proprietary code sets should obtain all necessary licenses from the owners of the code sets. NCQA disclaims all liability for use or accuracy of any third party codes contained in the specifications. CPT(R) contained in the Measure specifications is copyright 2004-2019 American Medical Association. LOINC(R) copyright 2004-2019 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2019 International Health Terminology Standards Development Organisation. ICD-10 copyright 2019 World Health Organization. All Rights Reserved. |
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| Disclaimer |
The performance Measure is not a clinical guideline and does not establish a standard of medical care, and has not been tested for all potential applications. THE MEASURE AND SPECIFICATIONS ARE PROVIDED "AS IS" WITHOUT WARRANTY OF ANY KIND. Due to technical limitations, registered trademarks are indicated by (R) or [R] and unregistered trademarks are indicated by (TM) or [TM]. |
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| Measure Scoring | Proportion | ||
| Measure Type | Outcome | ||
| Stratification |
None |
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| Risk Adjustment |
None |
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| Rate Aggregation |
None |
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| Rationale |
Dental caries is the most chronic disease among youth aged 6-19 years. Data from the National Health and Nutrition Examination Survey from 2015-2016 showed that approximately 45.8% of children and youth aged 2-19 years had total caries (untreated and treated). Prevalence of total dental caries (untreated and treated) in primary or permanent teeth increases with age, going from 21.4%, 50.5%, and 53.8% among ages 2-5, 6-11, and 12-19, respectively. Total dental caries was highest in Hispanic youths aged 2-19 at 57.1% compared to 48.1% for non-Hispanic black, 44.6% for non-Asian, and 40.4% for non-Hispanic white youth. Monitoring prevalence of untreated and total caries is vital to preventing and controlling oral disease (Fleming & Afful, 2018). Children who have dental decay or cavities are less likely to be in very good or excellent overall health than children without decay or cavities (Edelstein & Chinn, 2009). Children with decay are also more likely to have other oral health problems such as toothaches, broken teeth, and bleeding gums (Data Resource Center for Child and Adolescent Health, 2007). |
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| Clinical Recommendation Statement |
This is an outcome measure. As such, no clinical recommendations are included. |
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| Improvement Notation |
A lower score indicates better quality |
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| Reference |
Data Resource Center for Child and Adolescent Health, Child and Adolescent Health Measurement Initiative. (2007). 2007 National Survey of Children’s Health. Baltimore, MD: Author. |
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| Reference |
Edelstein, B. L., & Chinn, C. H. (2009). Update on disparities in oral health and access to dental care for America’s children. Academic Pediatrics, 9(6), 415-419. |
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| Reference |
Fleming, E., & Afful, J. (2018). Prevalence of total and untreated dental carries among youth: United States, 2015-2016. NCHS Data Brief No. 307. Hyattsville, MD: National Center for Health Statistics. |
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| Definition |
None |
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| Guidance |
This eCQM is a patient-based measure. This version of the eCQM uses QDM version 5.5. Please refer to the eCQI resource center (https://ecqi.healthit.gov/qdm) for more information on the QDM. |
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| Transmission Format |
TBD |
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| Initial Population |
Children, 6 months - 20 years of age, with a clinical oral evaluation during the measurement period |
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| Denominator |
Equals Initial Population |
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| Denominator Exclusions |
Exclude patients whose hospice care overlaps the measurement period |
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| Numerator |
Children who had a diagnosis of cavities or decayed teeth overlapping the measurement period |
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| Numerator Exclusions |
Not applicable |
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| Denominator Exceptions |
None |
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| Supplemental Data Elements |
For every patient evaluated by this measure also identify payer, race, ethnicity and sex |
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exists ( ["Patient Characteristic Birthdate": "Birth date"] BirthDate
where Global."CalendarAgeInMonthsAt" ( BirthDate.birthDatetime, start of "Measurement Period" ) >= 6
and Global."CalendarAgeInYearsAt" ( BirthDate.birthDatetime, start of "Measurement Period" ) < 20
)
and exists ( "Qualifying Encounters" )
"Initial Population"
Hospice."Has Hospice"
exists ( ["Diagnosis": "Dental Caries"] DentalCaries
where DentalCaries.prevalencePeriod overlaps "Measurement Period"
)
None
None
None
"Initial Population"
Hospice."Has Hospice"
exists ( ["Encounter, Performed": "Encounter Inpatient"] DischargeHospice
where ( DischargeHospice.dischargeDisposition ~ "Discharge to home for hospice care (procedure)"
or DischargeHospice.dischargeDisposition ~ "Discharge to healthcare facility for hospice care (procedure)"
)
and DischargeHospice.relevantPeriod ends during "Measurement Period"
)
or exists ( ["Intervention, Order": "Hospice care ambulatory"] HospiceOrder
where HospiceOrder.authorDatetime during "Measurement Period"
)
or exists ( ["Intervention, Performed": "Hospice care ambulatory"] HospicePerformed
where HospicePerformed.relevantPeriod overlaps "Measurement Period"
)
exists ( ["Patient Characteristic Birthdate": "Birth date"] BirthDate
where Global."CalendarAgeInMonthsAt" ( BirthDate.birthDatetime, start of "Measurement Period" ) >= 6
and Global."CalendarAgeInYearsAt" ( BirthDate.birthDatetime, start of "Measurement Period" ) < 20
)
and exists ( "Qualifying Encounters" )
exists ( ["Diagnosis": "Dental Caries"] DentalCaries
where DentalCaries.prevalencePeriod overlaps "Measurement Period"
)
["Encounter, Performed": "Clinical Oral Evaluation"] ValidEncounter where ValidEncounter.relevantPeriod during "Measurement Period"
["Patient Characteristic Ethnicity": "Ethnicity"]
["Patient Characteristic Payer": "Payer"]
["Patient Characteristic Race": "Race"]
["Patient Characteristic Sex": "ONC Administrative Sex"]
months between ToDate(BirthDateTime)and ToDate(AsOf)
years between ToDate(BirthDateTime)and ToDate(AsOf)
DateTime(year from Value, month from Value, day from Value, 0, 0, 0, 0, timezoneoffset from Value)
["Patient Characteristic Ethnicity": "Ethnicity"]
["Patient Characteristic Payer": "Payer"]
["Patient Characteristic Race": "Race"]
["Patient Characteristic Sex": "ONC Administrative Sex"]
| Measure Set |
Not applicable |
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|---|---|---|---|