Diabetes: Eye Exam
Identifying Attributes
Care Settings
Country
Publishing Organisation
Type of Quality Indicator
IOM Quality Dimension
Domain
Defining Attributes
Definition
Percentage of patients ≥18 to ≤75 years of age with diabetes and an active diagnosis of retinopathy in any part of the reporting quarter who had a retinal or dilated eye exam by an eye care professional during the reporting quarter OR diabetics with no diagnosis of retinopathy in any part of the reporting quarter who had a retinal or dilated eye exam by an eye care professional during the reporting quarter or in the 09 months prior to the reporting quarter.
Numerator
Patients with an eye screening for diabetic retinal disease. This includes diabetics who had one of the following: (1) Diabetic with a diagnosis of retinopathy during the reporting quarter and a retinal or dilated eye exam by an eye care professional during the reporting quarter (Procedure codes with ICD), (2) Diabetic with no diagnosis of retinopathy in the reporting quarter and a retinal or dilated eye exam by an eye care professional during the measurement quarter or within 09 months prior to the reporting quarter (Procedure codes without ICD).
Denominator
Total number of unique patients (≥18 to ≤75 years of age), with diabetes related outpatient visit/s during the reporting quarter and who had at least 2 diabetes related outpatient visits within 09 months (prior to the reporting quarter).
Exclusions
Patient with diagnosis of polycystic ovaries, gestational diabetes, or steroid-induced diabetes (within the denominator time-frame) and all ABM Mandate encounters.
Use of Risk Adjustment
Risk Adjustments
Stratifications
Collection and Reporting Attributes
Type of Data Collection
Data Collection Methods
Centrally collected claim data (KEH) and patient medical record.