eMeasure Title

Maternal Depression Screening

eMeasure Identifier (Measure Authoring Tool) 82 eMeasure Version number 5.1.000
NQF Number Not Applicable GUID 8e6c8479-99fd-4949-b0ad-24fa60fe4201
Measurement Period January 1, 20XX through December 31, 20XX
Measure Steward National Committee for Quality Assurance
Measure Developer National Committee for Quality Assurance
Endorsed By None
The percentage of children who turned 6 months of age during the measurement year, who had a face-to-face visit between the clinician and the child during child's first 6 months, and who had a maternal depression screening for the mother at least once between 0 and 6 months of life
This Physician Performance Measure (Measure) and related data specifications were developed by the National Committee for Quality Assurance (NCQA) with support from The Commonwealth Fund, a national, private foundation based in New York City that supports independent research on health care issues and makes grants to improve health care practice and policy. The views presented here are those of the author and not necessarily those of The Commonwealth Fund, its directors. officers, or staff. The Measure is copyrighted but can be reproduced and distributed, without modification, for noncommercial purposes (eg, use by healthcare providers in connection with their practices) without obtaining approval from NCQA. Commercial use is defined as the sale, licensing, or distribution of the Measure for commercial gain, or incorporation of the Measure into a product or service that is sold, licensed or distributed for commercial gain. All commercial uses must be approved by NCQA and are subject to a license at the discretion of NCQA. 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. (C) 2009-2017 National Committee for Quality Assurance. All Rights Reserved. 

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Measure Scoring Proportion
Measure Type Process
Risk Adjustment
Rate Aggregation
Maternal depression, also known as post-partum depression, is one of the most common perinatal complications; however, the disorder often remains unrecognized, undiagnosed, and untreated (VanLandeghem, 2006). Studies suggest that over 10 percent of mothers experience depression six weeks after giving birth, whether it is minor or major. Three to 25 percent of women experience major depression during the year following childbirth (Gaynes BN, 2005; Kessler RC, 1994). The incidence of depression may be higher in women who already have young children (VanLandeghem, 2006; Gaynes BN, 2005). Maternal depression can greatly affect mothers, their baby, and their family's well-being. It can have lasting effects on a mother's self-esteem and confidence as a mother (Epperson, 1999). 

Screening is important, as mothers with post-partum depression who are not treated can have symptoms that carry over into the second year post-partum. Mothers that have had post-partum depression are also more likely to have a recurrence with subsequent children. (Epperson, 1999). There are effective treatments available, but less than half of post-partum depression cases are ever diagnosed (Gibson, 2010). Less than 50 percent of mothers with an infant child are currently being screened for post-partum depression (Gjerdingen, Crow, McGovern, Miner, Center, 2009). This measure encourages clinicians to screen new mothers for depression.
Clinical Recommendation Statement
U.S. Preventive Services Task Force (USPSTF) (2016)
The USPSTF recommends screening for depression in the general adult population, including pregnant and postpartum women. Screening should be implemented with adequate systems in place to ensure accurate diagnosis, effective treatment, and appropriate follow-up.
Grade: B Recommendation

Bright Futures (2008)
Health care professionals should screen mothers on the following topics:

Mothers of one week old infants:   
Discuss health and depression, family stress, uninvited advice, parent role.  
Differentiate between short-term "baby blues" and postpartum depression, and counsel and refer as appropriate:
It may be helpful to advise women that the "postpartum blues" are a different entity from depression. The "blues," with characteristic tearfulness, anxiety and low mood, are relatively common but are transient, peaking at 3-5 days after birth and resolving by 10-14 days.

Mothers of one month old infants:
Discuss maternal health (postpartum, checkup, depression, substance abuse)

Mothers of two month old children:
Discuss maternal health (maternal postpartum, checkup and resumption of activities, depression)
Grade: Expert Consensus

Siu AL and the US Preventive Services Task Force. Screening for Depression in Adults: US Preventive Services Task Force Recommendation Statement. JAMA. 2016; 315(4): 380-387. 

Hagan, JF, Shaw JS, Duncan PM, eds. 2008. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Third Edition. Elk Grove, IL: American Academy of Pediatrics
Improvement Notation
Higher score indicates better quality
Epperson, C Neill, MD.  Postpartum Major Depression: Detection and Treatment. American Family Physician. April 15, 1999.
Gaynes BN, G. et al. Perinatal Depression: Prevalence, Screening Accuracy, and Screening Outcomes. Summary, Evidence Report/Technology Assessment No. 119. (Prepared by the RTI-University of North Carolina Evidence based Practice Center under Contract No. 290-02-0016.) AHRQ Publication No. 05-E006-1. Rockville, MD: Agency for Healthcare Research and Quality. February 2005.
Gibson J. Screening for Postpartum Depression Not Worth the Time or Money. March 27, 2010.
Gjerdingen D, Crow S, McGovern P, Miner M, Center B. Postpartum Depression Screening at Well-Child Visits: Validity of a 2-Question Screen and the PHQ-9. Annals of Family Medicine 7:63-70 (2009).
Hagan, JF, Shaw JS, Duncan PM, eds. 2008. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Third Edition. Elk Grove, IL: American Academy of Pediatrics.
Kessler RC, McGonagle KA, Zhao S, Nelson CB, Hughes M, Eshleman S, et al. Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States. Results from the National Comorbidity Survey. Arch Gen Psychiatry 1994;51:8-19.
VanLandeghem K.  National Academy for State Health Policy.  Financing Strategies for Medicaid Reimbursement of Maternal Depression Screening by Pediatric Providers.  April 2006.
Siu AL and the US Preventive Services Task Force. Screening for Depression in Adults: US Preventive Services Task Force Recommendation Statement. JAMA. 2016; 315(4): 380-387. 
The eMeasure specifies only patient's (baby) chart, looking for the newly allocated SNOMED codes that allow providers to record the screening and treatment of the mother, but the endorsed measure relies on notes from the patient's and mother's charts
Transmission Format
Initial Population
Children with a visit who turned 6 months of age in the measurement period
Equals Initial Population
Denominator Exclusions
Children with documentation of maternal screening or treatment for postpartum depression for the mother
Numerator Exclusions
Not Applicable
Denominator Exceptions
Supplemental Data Elements
For every patient evaluated by this measure also identify payer, race, ethnicity and sex

Table of Contents

Population Criteria

Data Criteria (QDM Variables)

Data Criteria (QDM Data Elements)

Supplemental Data Elements

Risk Adjustment Variables

Measure Set