eMeasure Title Pneumonia Vaccination Status for Older Adults
eMeasure Identifier
(Measure Authoring Tool)
127 eMeasure Version number 3
NQF Number 0043 GUID 59657b9b-01bf-4979-a090-8534da1d0516
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 National Quality Forum
Description
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine.
Copyright
Physician Performance Measure (Measures) and related data specifications were developed by the National Committee for Quality Assurance (NCQA). 

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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 CPT or other codes contained in the specifications.

CPT(R) contained in the Measure specifications is copyright 2004-2013 American Medical Association. LOINC(R) copyright 2004-2013 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2013 International Health Terminology Standards Development Organisation. ICD-10 copyright 2013 World Health Organization. All Rights Reserved.
Disclaimer
These performance Measures are not clinical guidelines and do not establish a standard of medical care, and have not been tested for all potential applications.

THE MEASURES AND SPECIFICATIONS ARE PROVIDED “AS IS” WITHOUT WARRANTY OF ANY KIND.
 
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Measure Scoring Proportion
Measure Type Process
Stratification
None
Risk Adjustment
None
Rate Aggregation
None
Rationale
Pneumonia is a common cause of illness and death in the elderly and persons with certain underlying conditions such as heart failure, diabetes, cystic fibrosis, asthma, sickle cell anemia, or chronic obstructive pulmonary disease (NHLBI, 2011). In 1998, an estimated 3,400 adults aged > 65 years died as a result of invasive pneumococcal disease (IPD) (CDC, 2003).
Among the 91.5 million US adults aged > 50 years, 29,500 cases of IPD, 502,600 cases of nonbacteremic pneumococcal pneumonia and 25,400 pneumococcal-related deaths are estimated to occur yearly; annual direct and indirect costs are estimated to total $3.7 billion and $1.8 billion, respectively. Pneumococcal disease remains a substantial burden among older US adults, despite increased coverage with 23-valent pneumococcal polysaccharide vaccine, (PPV23) and indirect benefits afforded by PCV7 vaccination of young children (Weycker, et al., 2011).
Vaccination has been found to be effective against bacteremic cases (OR: 0.34; 95% CI: 0.27–0.66) as well as nonbacteremic cases (OR: 0.58; 95% CI: 0.39–0.86). Vaccine effectiveness was highest against bacteremic infections caused by vaccine types (OR: 0.24; 95% CI: 0.09–0.66) (Vila-Corcoles, et al., 2009).
Clinical Recommendation Statement
The Advisory Committee on Immunization Practices’ (ACIP) Updated Recommendations for Prevention of Invasive Pneumococcal Disease Among Adults Using the 23-Valent Pneumococcal Polysaccharide Vaccine recommends pneumococcal vaccine for all immunocompetent individuals who are 65 and older or otherwise at increased risk for pneumococcal disease. Routine revaccination is not recommended, but a second dose is appropriate for those who received PPV23 before age 65 years for any indication if at least 5 years have passed since their previous dose (USPSTF, 1989; ACIP, 2010).
The major updates for the 2010 update are: 1) the indications for which PPSV23 vaccination is recommended now include smoking and asthma, and 2) routine use of PPSV23 is no longer recommended for Alaska Natives or American Indians aged <65 years unless they have medical or other indications for PPV23.
Improvement Notation
Higher score indicates better quality
Reference
Centers for Disease Control and Prevention. Advisory Committee on Immunization Practices. 2010. “Updated Recommendations for Prevention of Invasive Pneumococcal Disease Among Adults Using the 23-Valent Pneumococcal Polysaccharide Vaccine (PPSV23).” MMWR 59(34):1102-6.
Reference
Centers for Disease Control and Prevention. 2003. “Public health and aging: influenza vaccination coverage among adults aged >50 years and pneumococcal vaccination coverage among adults aged >65 years—United States, 2002.” MMWR 52:987–92.
Reference
National Heart, Lung and Blood Institute. 2011. “Pneumonia.” http://www.nhlbi.nih.gov/health/dci/Diseases/pnu/pnu_whatis.html
Reference
Weycker, D., D. Strutton, J. Edelsberg, R. Sato, L.A. Jackson. 2011. “Clinical and Economic Burden of Pneumococcal Disease in Older US Adults.” Vaccine 28(31): 4955-60.
Reference
Vila-Corcoles, A., E. Salsench, T. Rodriguez-Blanco, O. Ochoa-Gondar, C. de Diego, A. Valdivieso, I. Hospital, F. Gomez-Bertemeu, X. Raga. 2009. “Clinical effectiveness of 23-valent pneumococcal polysaccharide vaccine against pneumonia in middle-aged and older adults: A matched case-control study.” Vaccine 27(10):1504-10.
Definition
None
Guidance
It is recommended that patients 65 years of age or older receive one pneumococcal vaccination in their lifetime.
Transmission Format
None
Initial Patient Population
Patients 65 years of age and older with a visit during the measurement period
Denominator
Equals Initial Patient Population
Denominator Exclusions
None
Numerator
Patients who have ever received a pneumococcal vaccination
Numerator Exclusions
Not Applicable
Denominator Exceptions
None
Measure Population
Not Applicable
Measure Observations
Not Applicable
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 Data Elements)

Reporting Stratification

Supplemental Data Elements




Measure Set
None