Proportion of Patients With a Chronic Condition That Have a Potentially Avoidable Complication During a Calendar Year

Identifying Attributes

Care Settings
Primary Care
Country
United States of America
Publishing Organisation
Payment program, public reporting, quality improvement
Type of Quality Indicator
Outcome
IOM Quality Dimension
Effectiveness
Domain
Other Clinical

Defining Attributes

Definition

Percent of adult population aged 18+ years who were identified as having at least one of the following six chronic conditions: Asthma, Chronic Obstructive Pulmonary Disease (COPD), Coronary Artery Disease (CAD), Heart Failure (HF), Hypertension (HTN), or Diabetes Mellitus (DM), were followed for at least one-year, and had one or more potentially avoidable complications (PACs) during the most recent 12 months.

Numerator

Number of patients with at least one of the following six chronic conditions: Asthma, Chronic Obstructive Pulmonary Disease (COPD), Coronary Artery Disease (CAD), Heart Failure (HF), Hypertension (HTN), or Diabetes Mellitus (DM), and had one or more potentially avoidable complications (PACs), during the most recent 12 months.

Denominator

Adult patients aged 18+ years who were identified as having at least one of the following six chronic conditions: Asthma, Chronic Obstructive Pulmonary Disease (COPD), Coronary Artery Disease (CAD), Heart Failure (HF), Hypertension (HTN), or Diabetes Mellitus (DM), and were followed for at least 12 months.

Exclusions

Patients are excluded from the measure if they are less than 18 years of age, have an incomplete episode of care (less than 18 months of claims), have an enrolment gap of more than 30 days, or have outlier costs for the most recent 12 months of claim costs. Claims are excluded from the episode if they are for services that are not relevant to the chronic condition.

Use of Risk Adjustment
Yes
Risk Adjustments
Stratifications

None

Collection and Reporting Attributes

Type of Data Collection
Administrative data
Data Collection Methods

Reporting is specific to sub-program

Frequency of Data Collection
Frequency of Data Collection in Days
Reporting Methods
Reporting Frequency
Reporting Frequency in Days
Indicator Has Recommended Targets
No

Source and Reference Attributes

Evidence Source
Technical Specifications
Link to Measurement Tools
Quality Indicator Confirmed to be Part of a Program Used to Monitor Quality and Safety of Care Among Older People at a Population-Level between 2012-2022
Yes
Assessed by the Australian Consortium for Aged Care Collaborators as Generally Containing Good Properties (Importance and Scientific Acceptability)
No
Australian Consortium for Aged Care Endorsed
No
Identified by PHARMA-Care Project
No
Upload Date
02 December 2025