NQMC uses standard terminology also known as "Controlled Vocabulary Concepts" to classify various measure attributes represented in the NQMC measure summary. This standard "classification scheme" makes it easier to search for and retrieve information from the NQMC Web site. In addition, the scheme standardizes key measure attributes to facilitate review and comparison of the measures.
NQMC classifies the following attributes:
New vocabulary concepts are added to the classification scheme
as needed. Refer to the Glossary for definitions of select terms.
Allowance for Patient or Population Factors
The following concepts classify analytic considerations made for the measure based on patient or population factors or characteristics:
- Analysis by high-risk subgroup (stratification by vulnerable populations)
- Analysis by subgroup (stratification by individual factors, geographic factors, etc.)
- Case-mix adjustment
- Paired data at patient level
- Risk adjustment devised specifically for this measure/condition
- Risk adjustment method widely or commercially available
The following concepts classify the current use of the measure by quality initiative and constituency:
- Accreditation
- Collaborative inter-organizational quality improvement
- Decision-making by businesses about health-plan purchasing
- Decision-making by consumers about health plan/provider choice
- Decision-making by health plans about provider contracting
- Decision-making by managers about resource allocation
- External oversight/Department of Defense/TRICARE
- External oversight/Health plans
- External oversight/Indian Health Service
- External oversight/Maternal and Child Health Bureau
- External oversight/Medicaid
- External oversight/Medicare
- External oversight/Other national programs
- External oversight/Prison health care systems
- External oversight/Regional, county, or city agencies
- External oversight/State government program
- External oversight/Veterans Health Administration
- Internal quality improvement
- Monitoring and planning
- Monitoring health state(s)
- National health care facility monitoring
- National health policymaking
- National reporting
- Pay-for-performance
- Pay-for-reporting
- Population health improvement
- Professional certification
- Public reporting
- Quality of care research
- Regional county, or city health policymaking
- State/Provincial health policymaking
The following concepts classify the data sources necessary to implement the measure:
- Administrative clinical data
- Administrative management data
- Clinical training documentation
- Documentation of organizational self-assessment
- Electronic health/medical record
- External audit
- Health professional survey
- Imaging data
- Inspections/Site visits
- Laboratory data
- National public health data
- Organizational policies and procedures
- Paper medical record
- Patient/Individual survey
- Pharmacy data
- Provider characteristics
- Region, county, or city public health data
- Registry data
- Special or unique data
- State/Province public health data
Denominator Sampling Frame
The following concepts classify cases/events that are potentially eligible for inclusion in the denominator of the measure:
- Clinical information
- Enrollees or beneficiaries
- Equipment/Supplies
- Geographically defined
- Health care or public health organization
- Organizationally defined (non-health care organizations)
- Patients associated with provider
- Professionals/Staff
- Other
Denominator (Index) Event or Characteristic
The following concepts classify the event or characteristic that defines eligibility for inclusion in the denominator group for the measure:
- Clinical Condition
- Diagnostic Evaluation
- Encounter
- Geographic Location
- Health Care/Public Health Organization Characteristic
- Health Professional Characteristic
- Institutionalization
- Patient/Individual (Consumer) Characteristic
- Therapeutic Intervention
The following concepts classify the time period in which occurrences identified as potentially eligible for inclusion in the denominator for the measure are reviewed to determine whether or not they are finally included:
- Does not apply to this measure
- Time window brackets index event
- Time window follows index event
- Time window precedes index event
Disease/Condition concepts are classified using Medical Subject Headings (MeSH) produced by the U.S. National Library of Medicine (NLM), along with other controlled vocabularies, including:
- Healthcare Common Procedure Coding System (HCPCS)
- International Classification of Diseases – Clinical Modification (ICD-9-CM)
- Physician Data Query (PDQ)
- Standard Product Nomenclature (SPN)
- Systemized Nomenclature of Medicine (Clinical Terms) (SNOMED CT)
- UMLS Metathesaurus (MTH)
- Universal Medical Device Nomenclature System (UMDNS)
The following concepts classify denominator exclusions/exceptions made for the measure:
- Medical factors addressed
- Patient factors addressed
- System factors addressed
Health Services Administration
Health Services Administration concepts are classified using Medical Subject Headings (MeSH) produced by the U.S. National Library of Medicine (NLM), along with other controlled vocabularies, including:
- Healthcare Common Procedure Coding System (HCPCS)
- International Classification of Diseases – Clinical Modification (ICD-9-CM)
- Physician Data Query (PDQ)
- Standard Product Nomenclature (SPN)
- Systemized Nomenclature of Medicine (Clinical Terms) (SNOMED CT)
- UMLS Metathesaurus (MTH)
- Universal Medical Device Nomenclature System (UMDNS)
The following concepts classify interpretation of the score according to the desired value:
- Desired value is a higher score
- Desired value is a lower score
- Desired value is a passing score (relative to a defined benchmark)
- Desired value is a score falling within a defined interval
- Desired value is absence of a characteristic
- Desired value is presence of a characteristic
- Does not apply to this measure (i.e., there is no pre-defined preference for the measure score)
Institute of Medicine (IOM) Care Need
The following concepts classify the IOM Care Need categories according to the measure's primary clinical component:
- End of Life Care
- Getting Better
- Living with Illness
- Staying Healthy
- Not within an IOM Care Need
Institute of Medicine (IOM) Domain
The following concepts classify the IOM Domain categories according to the measure's primary clinical component:
- Effectiveness
- Efficiency
- Equity
- Patient-centeredness
- Safety
- Timeliness
- Not within an IOM Domain
Least Aggregated Level of Services Delivery Addressed
The following concepts classify the most discrete level of services delivery for which the measure was developed:
- Clinical Practice or Public Health Sites
- Individual Clinicians or Public Health Professionals
- Metropolitan Statistical Areas/Health Services Areas
- Multisite Health Care or Public Health Organizations
- National
- Regional, County, or City
- Single Health Care Delivery or Public Health Organizations
- State/Provincial
Measure Domain (Primary, Secondary)
The following concepts classify the primary and/or secondary domain of each measure:
- Clinical Quality Measures: Process
- Clinical Quality Measures: Access
- Clinical Quality Measures: Outcome
- Clinical Quality Measures: Structure
- Clinical Quality Measures: Patient Experience
- Related Health Care Delivery Measures: User-enrollee Health State
- Related Health Care Delivery Measures: Management
- Related Health Care Delivery Measures: Use of Services
- Related Health Care Delivery Measures: Cost
- Clinical Efficiency Measures: Efficiency
- Population Health Quality Measures: Population Process
- Population Health Quality Measures: Population Access
- Population Health Quality Measures: Population Outcome
- Population Health Quality Measures: Population Structure
- Population Health Quality Measures: Population Experience
- Related Population Health Measures: Population Health State
- Related Population Health Measures: Population Management
- Related Population Health Measures: Population Use of Services
- Related Population Health Measures: Population Cost
- Related Population Health Measures: Population Health Knowledge
- Related Population Health Measures: Social Determinants of Health
- Related Population Health Measures: Environment
- Population Efficiency Measures: Population Efficiency
Measure Specifies Disaggregation
This field classifies whether the measure can be disaggregated based on variant approaches to splitting the denominator or numerator:
- Measure is disaggregated into categories based on different definitions of the denominator and/or numerator
- Does not apply to this measure
The following concepts classify the setting(s) for which the measure was developed:
- Ambulatory/Office-based Care
- Ancillary Services
- Behavioral Health Care
- Community Health Care
- Emergency Medical Services
- Home Care
- Hospices
- Hospitals
- Long-term Care Facilities
- Managed Care Plans
- National Public Health Programs
- Regional, County, or City Public Health Programs
- Rehabilitation Centers
- Residential Care Facilities
- Rural Health Care
- State/Provincial Public Health Programs
- Substance Use Treatment Programs/Centers
- Other
Numerator Search Strategy
The following concepts classify the types of situations that isolate cases for inclusion in the numerator of the measure:
- Encounter
- Episode of care
- Fixed time period or point in time
- Institutionalization
The following concepts classify the measure developer(s), measure submitter(s), and measure endorser(s) by major designation or function:
- Academic Affiliated Research Institute
- Academic Institution
- Accountable Care Organization
- Clinical Quality Collaboration
- Clinical Specialty Collaboration
- Disease Specific Society
- Federal Government Agency [U.S.]
- For Profit Organization
- For Profit Research Organization
- Government Affiliated Research Institute
- Health Care Accreditation Organization
- Health Care Quality Collaboration
- Hospital/Medical Center
- Independent Author(s)
- Independent Expert Panel
- International Agency
- Managed Care Organization
- Manufacturer
- Medical Specialty Society
- National Government Agency [Non-U.S.]
- Nursing Home/Extended Care Facility
- Nonprofit Organization
- Nonprofit Research Organization
- Professional Association
- State/Local Government Agency [Non-U.S.]
- State/Local Government Agency [U.S.]
Professionals Involved in the Delivery of Health Services
The following concepts classify the professionals involved in delivering the services addressed by the measure:
- Advanced Practice Nurses
- Allied Health Personnel
- Chiropractors
- Clergy
- Clinical Administrators/Managers
- Clinical Laboratory Personnel
- Dentists
- Dietitians
- Emergency Medical Technicians/Paramedics
- Health Educators
- Midwife
- Nurses
- Occupational Therapists
- Optometrists
- Pharmacists
- Physical Therapists
- Physician Assistants
- Physicians
- Podiatrists
- Psychologists/Non-physician Behavioral Health Clinicians
- Public Health Administrators/Managers
- Public Health Professionals
- Respiratory Care Practitioners
- Social Workers
- Speech-Language Pathologists
- Does not apply to this measure (e.g., measure is not provider specific)
The following concepts classify methods used to score the measure:
- Composite/Scale
- Count
- Dichotomous
- Frequency Distribution
- Mean/Median
- Rate/Proportion
- Ratio
- Weighted Score
The following concepts classify the type and time frame of comparison for the measure:
- External comparison at a point in, or interval of, time
- External comparison of time trends
- Internal time comparison
- Prescriptive standard
The following concepts classify the status of the measure regarding its use within the past three years by health-related organizations:
- Current routine use
- Pilot testing
Statement of Acceptable Minimum Sample Size
This field classifies whether the measure defines a minimum sample size for the denominator:
For the purposes of searching, NQMC indexes and classifies the target population by age, gender, and vulnerable populations. The following concepts are used:
Age
- Infant: Very low birth weight
- Infant: Low birth weight
- Infant: Newborn
- Infant: 1 to 23 months old
- Child: Pre-school; 2 to 5 years old
- Child: 6 to 12 years old
- Adolescent: 13 to 18 years old
- Adult: 19 to 44 years old
- Adult: 45 to 64 years old
- Adult: 65 to 79 years old
- Adult: 80 years old and older
Gender
- Either male or female
- Female (only)
- Male (only)
Vulnerable Populations
- Children
- Disabled
- Frail Elderly
- Homeless
- Illiterate/Low-literate Populations
- Immigrants
- Medically Uninsured
- Mentally Ill
- Minority Groups
- Non-English Speaking Populations
- Poverty Populations
- Prisoners
- Rural Populations
- Terminally Ill
- Transients/Migrants
- Urban Populations
- Women
Treatment/Intervention concepts are classified using Medical Subject Headings (MeSH) produced by the U.S. National Library of Medicine (NLM), along with other controlled vocabularies, including:
- Healthcare Common Procedure Coding System (HCPCS)
- International Classification of Diseases – Clinical Modification (ICD-9-CM)
- Physician Data Query (PDQ)
- Standard Product Nomenclature (SPN)
- Systemized Nomenclature of Medicine (Clinical Terms) (SNOMED CT)
- UMLS Metathesaurus (MTH)
- Universal Medical Device Nomenclature System (UMDNS)
Type of Evidence Supporting the Criterion of Quality for the Measure
The following concepts classify the types of evidence supporting the criterion of quality specified for the measure:
- A clinical practice guideline or other peer-reviewed synthesis of the research evidence
- A formal consensus procedure, involving experts in relevant clinical, methodological, public health and organizational sciences
- A systematic review of the research literature (e.g., Cochrane Review)
- Focus groups
- One or more research studies published in a National Library of Medicine (NLM) indexed, peer-reviewed journal
The following concepts classify the type of health state for the measure:
- Adverse Health State
- Clinically Diagnosed Condition
- Death
- Functional Status
- Health Risk State or Behavior
- Individually Reported Health State
- Physiologic Health State (Intermediate Outcome)
- Proxy for Health State
- Proxy for Outcome
