Definition of the included indicators of health care quality

Short name

Dimension

Numerator

Denominator

Codes used

Composition: General practitioners

Composition

General practitioners

All providers

FAGR: 1, 2

Composition: Ophthalmologists

Composition

Ophthalmologists

All providers

FAGR: 5

Composition: Surgeons

Composition

Surgeons

All providers

FAGR: 6–9, 11, 13, 14

Composition: Multidisciplinary practices

Composition

Multidisciplinary practices

All providers

flagged by data provider

Composition: Therapists

Composition

Therapists

All providers

resulting from originating dataset

Composition: Internists

Composition

Internists

All providers

FAGR: 3, 23–33

Composition: Orthopaedics

Composition

Orthopaedics

All providers

FAGR: 10, 12

Composition: Psychologists and psychotherapists

Composition

Psychologists and psychotherapists

All providers

FAGR: 44, 47, 51, 53, 58–61, 68, 69

Composition: Other disciplines

Composition

All outpatient providers – outpatient providers in other categories

All providers

Composition: Urologists

Composition

Urologists

All providers

FAGR: 67

Composition: Rehabilitation facilities

Composition

Rehabilitation facilities

All providers

resulting from originating dataset

Composition: Hospitals

Composition

Hospitals

All providers

resulting from originating dataset

Composition: Proportion of care-dependent persons in cluster

Composition

Persons with approved care-dependency according to 11^th Book of the German Social Code assigned to cluster

All persons assigned to cluster

Composition: Number of providers in cluster

Composition

Composition: Number of patients in cluster (network dataset)

Composition

Composition: Number of patients in cluster (cohort dataset)

Composition

Average number of comorbidities

Morbidity

Number of comorbidities from selected diagnoses

ICD-10-GM: J45.- (Asthma); J43.-, J44.- (COPD); I10–I15 (Hypertension); I50.1 (Heart Failure); I25.- (Coronary Heart Disease); I61.- I63.- I64.- (Apoplexy); F00–F03 (Dementia); E11.- (Type 2 Diabetes mellitus); M15–M19 (Osteoarthritis); M80–M82 (Osteoporosis); F32.- F33.- F34.1 (Depression)

COC Asthma

Continuity of Care

Continuity of Care Index for persons with index disease and >= 2 visits to selected providers, describes the contribution of care to the person between providers. 0=each visit to a different provider, 1= all visits to the same provider

ICD-10-GM: J45.-

COC COPD

Continuity of Care

ICD-10-GM: J43.- J44.-

COC Dementia

Continuity of Care

ICD-10-GM: F00.- F01.- F02.- F03.-

COC Diabetes

Continuity of Care

ICD-10-GM: E11.-

COC Heart Failure

Continuity of Care

ICD-10-GM: I50.1

SECON Asthma

Continuity of Care

Sequential Continuity Index for persons with index disease and >= 2 visits to selected providers; describes the ratio of sequential pairs of visits to the same provider. 0=each visit to a different provider that the prior visit, 1=all follow-up visits made to the same provider.

ICD-10-GM: J45.-

SECON COPD

Continuity of Care

ICD-10-GM: J43.- J44.-

SECON Dementia

Continuity of Care

ICD-10-GM: F00.- F01.- F02.- F03.-

SECON Diabetes

Continuity of Care

ICD-10-GM: E11.-

SECON Heart Failure

Continuity of Care

ICD-10-GM: I50.1

UPC Asthma

Continuity of Care

Usual Provider Continuity Index for persons with index disease and >= 2 visits to selected providers, describes the density of care made by a primary provider. 0=every visit to a different provider, 1=all visits to the same provider.

ICD-10-GM: J45.-

UPC COPD

Continuity of Care

ICD-10-GM: J43.- J44.-

UPC Dementia

Continuity of Care

ICD-10-GM: F00.- F01.- F02.- F03.-

UPC Diabetes

Continuity of Care

ICD-10-GM: E11.-

UPC Heart Failure

Continuity of Care

ICD-10-GM: I50.1

Asthma: Prevalence

Morbidity

Persons with bronchial asthma

All persons

ICD-10-GM: J45.-

Asthma: Spirometry

Outcome indicators

Persons with bronchial asthma and spirometry

Initially diagnosed asthmatics

ICD-10-GM: J45.-, no such diagnosis in the prior data year. GONR: 03330 04330 04419 04534 13255 13560 13660 27330 04530 13650 36881 OPS: 1719 1712 (spirometry)

Asthma: Inhalative medication

Process indicators

inhalative medication

Asthmatics with medication

ICD-10-GM: J45.-. ATC: R03AC02 R03AC03 R03AC04 R03BB01 R03BA R03AC12 R03AC13(inhalative medication); R03DA04 R03CC02 R03CC03 R03CC04 R03CC14 H02AB06 H02AB07 H02AB04 H02AB03 R03DC03 R03AK07 R03AK06 H02AB03 H02AB04 H02AB06 H02AB07 R03DX05 R03DA04 R03CC (other medication);

Asthma: ICS

Process indicators

long-term medication of inhalative corticosteroids

Asthmatics with long-term medication

ICD-10-GM: J45.-; ATC: R03BA (ICS); R03AC12 R03AC13 R03DC03 R03AK07 R03AK06 H02AB03 H02AB04 H02AB06 H02AB07 R03DX05 R03DA04 R03CC (other long-term medication)

Medication: PRISCUS

Process indicators

Persons over 65 years with medication from PRISCUS list

Persons over 65 years

ATC: C01EB03M01AB01 M01AB51 M02AA23 M02AA73 S01BC01 M01AB11 M01AE03 M02AA10 M01AE53 M01AA01 M02AA01 M01AA51 R05XA10 M01BA01 M01AC01 M02AA07 S01BC06 M01AC06 M01AC56 M01AH05 (NSAID). N02AB02 N02AB52 N02AB72 N02AG03 (opiod analgetics); C08DA81 C01BA01 C01BA51 C01BA71 C01BC04 C07AA07 C07AA57 C07BA07 C01AA05 C01AA55 C01AA02 C01AA52 C01AA08 C01AA58 (antiarrythmic agents); J01XE01 J01XE51 (antibiotics); A03AA A03AB A03CA A03DA A03E N04A R03BB S01FA R03AL (anticholinergic agents); R06AB04 R06AB54 R06AX32 (if year <2015) R06AX07 R06AX57 G04BD04 G04BD04 G04BD07 D04AA14 R06AA04 R06AA54 N05BB01 N05BB51 R06AX33 D04AA13 R01AC09 R06AB03 R01AC08 N05BB52 (antihistamines); B01AC05 B01AC22 (anticoagulants); N06AA09 N06CA01 N06AA12 N06AA02 N06AA04 N06AA21 N06AA06 (antidepressives); N06AB03 (SSRI): N06CA03 N06CA07 N06AF04 (MAO-inhibitors). A04AB02 A04AB52 (antiemetics); C02CA04 G04CA05 C02CA01 C02LE01 C02CA08 G04CA03 (alpha-blockers); C02AC01 N02CX02 N07BB06 S01EA04 C02LC01 C02LC51 C02AA02 N05AX15 N05AX16 C02AA52 C02LA01 C02LA51 C02LA71 C02AB01 C02LB01 C02AB02 (cardio-vascular medication); C08CA05 (calcium-channel blockers); N05AC02 N05AB02 N05AA02 N05AB03 N05AD01 N05AH03 N05AH02 (neuroleptics); N02CA01 N02CA51 N02CA71 C06AA02 C06AA50 N02CA02 N02CA52 N02CA72 N04BC03 N06DX07 N06DX57 (ergotamin and derivates); A06AA01 A06AA51 (laxants); M03BX01 M03BX07 (muscle relexants); N05BA02 N05BA01 N05CD01 N05BA05 N05BA08 N05BA11 N05BA09 N05CD02 N05CD03 N05BA03 (long-acting benzodiazepines); N05BA12 N05CD07 N05CD05 N05BA06 N05BA56 N05BA04 N05CD06 N05CD09 N05CF02 N05CF01 N05CF03 (short- and medium-acting benzodiazepines and z-drugs); N05CM21 R06AA09 A04AB56 R06AA59 A04AB05 D04AA32 N01BX06 N05CM20 R06AA02 S01Gx16 A04Ab55 D04AA82 N05CX07 R06AA52 (other sedatives); C04AD03 C04AX21 C04AE02 N06DX13 N06BX03 (antidementia, vasodilatatives); N03AA02 N05CA24 (antiepileptics)

Medication: Beta-Blocker after myocardial infarction

Process indicators

Persons over 65 years with beta-blocker after myocardial infarction

Persons over 65 years after myocardial infarction

ICD-10-GM: I25.2 I21.- I22.-; ATC: C07 (beta blocker)

Medication: ACE-inhibitor upon hypertension and renal insufficiency

Process indicators

Persons over 65 years with ACE inhibitor, hypertensions & renal insufficiency

Persons over 65 years with hypertension and renal insufficiency

ICD-10-GM: I10.- I11.- I12.- I13.- I15.- (hypertension); N18.- I13.2 I13.15 N19.- (renal failure); ATC: C09A C09BA C09BB C09BX.

Medication: ACE-inhibitor upon heart failure

Process indicators

Persons over 65 years with ACE inhibitor and heart failure

Persons over 65 years with heart failure

ICD-10-GM: I50.1; ATC: C09A C09BA C09BB C09BX (ACE inhibitors)

Process indicators

Persons over 65 years with beta-blocker and bronchial asthma

Persons over 65 years with bronchial asthma

ICD-10-GM: J45.-; ATC: C07 (beta blocker)

Medication: Electrolyte check upon diuretics

Process indicators

Persons over 65 years with diuretics and check of electrolytes

Persons over 65 years with diuretics

ATC: C03 C08G C09BA C09DA B05BC C02L C07C C07D (diuretics); GONR: 32081 32082 32082 32082 (check of electrolytes)

Medication: Polypharmacy

Process indicators

Persons over 65 years with at least 5 prescription medications

Persons over 65 years with prescription medication

Ambulatory care sensitive cases

Outcome indicators

Persons with hospital admissions due to ambulatory care sensitive diagnosis

All persons

ICD-10-GM: I20 I25.0 I25.1 I25.5 I25.6 I25.8 I25.9 (ischaemic heart diseases); I50.- (heart failure); I05.- I06.- I08.0 I49.8 I49.9 I67.2 I67.4 I70.- I73.- I78.- I83.- I86.- I87.- I95.- I80.0 I80.80 R00.0 R00.2 R47.0 (other diseases of the circulatory system); J20.- J21.- J40.- J41.- J42.- J43.- J44.- J47.- (bronchitis & COPD); F10.- F11.- (mental and behavioural disorders due to use of alcohol or opioids); M42.- M47.- M53.- M54.- (back pain); I10.- I11.- I12.- I13.- I14.- I15 .- (hypertension); K52.2 K52.8 K52.9 K59.0 K57.- K58.- (gastroenteritis and other diseases of intestines); A01.- A02.- A04.- A05.- A07.- A08.- A09.- (intestinal infectious diseases); J10.- J11.- J13.-J14.-J15.3 J15.4 J15.7 J15.8 J16.8 J18.0 J18.1 J18.8 J18.9 (influenza and pneumonia); H66.- J01.- J02.- J03.- J06.- J31.- J32.- J35.- (Ear/nose/throat infections); F32.- F33.- (depressive disorders); E10.2 E10.3 E10.4 E10.5 E10.6 E10.8 E11.- E13.6 E13.7 E13.9 E14.- E16.2 (diabetes mellitus); M67.4 M71.3 M75.- M76.- M77.- M79.- (gonarthrosis); G56.0 M67.4 M71.3 M75.- M76.- M77.- M79.- (soft tissue disorders); F40.- F41.-F43.-F45.-F50.0F50.2 F60.- (other avoidable mental and behavioural disorders); H25.- H40.- (diseases of the eye); N30.- N34.- N39.0 (diseases of urinary system); G47.- (sleep disorders); A46.- L01.-L02.- L04.- L08.0 L08.9 L60.0 L72.1 L98.0(diseases of the skin and subcutaneous tissue); D50.- D51.- D52.- D56.-D53.1 E40.- E41.- E42.- E43.- E44.- E45.- E46.- E47.- E48.- E49.- E50.- E51.- E52.- E53.- E54.- E55.- E56.- E57.- E58.- E59.- E60.- E61.- E62.- E63.- E64.- R63.6 (malnutrition & nutritional deficiencies); K02.- K04.- K05.- K06.- K08.- K12.- K13.- (dental diseases)

COPD: Prevalence

Morbidity

Persons with diagnosed COPD

All persons

ICD-10-GM: J43.- J44.-

COPD: Inhalative medication

Process indicators

Persons with COPD and inhalative medication

Persons with COPD

ICD-10-GM: J43.- J44.-; ATC: R03A R03B (Inhalative medication)

COPD: Acute inpatient treatment

Outcome indicators

Persons with acute inpatient treatment of COPD

Persons with COPD

ICD-10-GM: J43.- J44.-

COPD: Respiratory therapy

Process indicators

Persons with COPD and respiratory therapy

Persons with COPD

ICD-10-GM: J43.- J44.-; POSNR: 302-304 501-503 601 6210 6301 6306 (respiratory therapy)

COPD: influenza vaccination

Process indicators

Persons with COPD and influenza vaccination

Persons with COPD

ICD-10-GM: J43.- J44.- Z25.1

COPD: Specific beta-blocker therapy

Process indicators

Persons with COPD and specific beta-blocker therapy

Persons with COPD

ICD-10-GM: J43.- J44.-; ATC: R03AC12 R03AC13 (specific beta blocker)

COPD: Specific anticholinergic therapy

Process indicators

Persons with COPD and specific anticholinergic therapy

Persons with COPD

ICD-10-GM: J43.- J44.-; ATC: R03BB04 (specific anticholinergic)

COPD: Oral corticosteroids

Process indicators

Persons with COPD and oral corticosteroids

Persons with COPD

ICD-10-GM: J43.- J44.-; ATC: H02AB01 H02AB02 H02AB03 H02AB04 H02AB05 H02AB06 H02AB07 H02AB08 H02AB09 (corticosteroids)

CVD: Prevalence hypertension

Morbidity

Persons with hypertension

All persons

ICD-10-GM: I10.- I11.- I12.- I13.- I15.-

CVD: Medication for hypertension

Process indicators

Persons with hypertension and pharmacotherapy

Persons with hypertension

ICD-10-GM: I10.- I11.- I12.- I13.- I15.- ATC: C02 (antihypertensives)

CVD: Prevalence heart failure

Morbidity

Persons with heart failure

All persons

ICD-10-GM: I50.1

CVD: Echocardiography upon heart failure

Process indicators

Persons with suspected heart failure and echocardiography

Persons with suspected heart failure

ICD-10-GM: I50.1 (suspected); GONR: 13545 33020 3302133022 33030 33031

CVD: 12-lead ECG upon heart failure

Process indicators

Persons with suspected heart failure and 12-lead ECG

Persons with suspected heart failure

ICD-10-GM: I50.1 (suspected); GONR: 03321 04321 13250 13251 27320 27321

CVD: ACE-inhibitor upon heart failure

Process indicators

Persons with heart failure treated with ACE-inhibitor or AT1-blocker

Persons with heart failure

ICD-10-GM: I50.1; ATC: C09

CVD: Beta-blocker upon heart failure

Process indicators

Persons with heart failure and beta-blocker

Persons with heart failure

ICD-10-GM: I50.1; ATC: C07

CVD: Anticoagulant upon atrial fibrillation and heart failure

Process indicators

Persons with heart failure and atrial fibrillation and anticoagulants

Persons with heart failure and artrial fibrillation

ICD-10-GM: I50.1. I48.1; ATC: B01AA01-B01AA08 B01AC04-B01AC08 B01AC18 B01AC22-B01AC24 B01AC34 B01AC36 B01AC56

CVD: Referral to cardiologist upon heart failure

Process indicators

Persons with suspected heart failure and referral to cardiologist

Persons with suspected heart failure

ICD-10-GM: I50.1 (suspected); GONR: 13540-13542 32084. FAGR: 28

CVD: Acute inpatient treatment of heart failure

Outcome indicators

Persons with heart failure and acute inpatient treatment of heart failure

Persons with heart failure

ICD-10-GM: I50.1 (hospital discharge diagnosis)

CVD: Apoplexy treatment in stroke unit

Process indicators

Persons with acute apoplexy and treatment in stroke-unit

Persons with acute apoplexy

ICD-10-GM: I61.- I63.- I64.-; OPS: 8981

CVD: Platelet aggregation inhibitor upon stable chronic coronary heart disease

Process indicators

Persons with stable chronic coronary heart disease and platelet aggregation inhibitor

Persons with stable chronic coronary heart disease

ICD-10-GM: I25.-; ATC: B01AC06 B01AC04

CVD: Statins upon coronary heart disease

Process indicators

Persons with coronary heart disease and statins

Persons with coronary heart disease

ICD-10-GM: I20.- I22.- I23.- I24.- I25.-; ATC: C10AA C10BA C10BX (statins)

CVD: Anti-hypertensive therapy upon coronary heart disease and hypertension

Process indicators

Persons with coronary heart disease, hypertension and anti-hypertensive therapy

Persons with coronary heart disease and hypertension

ICD-10-GM: I20.- I22.- I23.- I24.- I25.- (coronary heart disease); I10.- I11.- I12.- I13.- I15.- (hypertension); ATC: C02 C03 C07 C08 C09 (anti-hypertensive medication)

Dementia: Prevalence

Morbidity

Persons with dementia

All persons

ICD-10-GM: F00.- F01.- F02.- F03.-

Dementia: B12 and TSH

Process indicators

Persons with incident dementia and determination of B12 and TSH

Persons with incident dementia

ICD-10-GM: F00.- F01.- F02.- F03.- no such diagnosis in the prior data year; GONR: 32373 32101 (B12/TSH analysis)

T2D: Prevalence

Morbidity

Persons with type 2 diabetes mellitus

All persons

ICD-10-GM: E11.-

T2D: HbA1c

Process indicators

Persons with type 2 diabetes mellitus and check of HbA1c

Persons with type 2 diabetes mellitus

ICD-10-GM: E11.-; GONR:32094 90321 90310 90310A (HbA1c check)

T2D: Ophthalmological examination

Process indicators

Persons with type 2 diabetes mellitus and ophthalmological examination

Persons with type 2 diabetes mellitus

ICD-10-GM: E11.- GONR: 06210 06211 06212 (ophthalmological examination)

T2D: Fundus examination

Process indicators

Persons with type 2 diabetes mellitus and fundus examination

Persons with type 2 diabetes mellitus

ICD-10-GM: E11.-; GONR: 06331 06333 (fundus examination)

T2D: Triglycerides and cholesterol

Process indicators

Persons with type 2 diabetes mellitus and check of triglycerides, LDL- and HDL-cholesterol

Persons with type 2 diabetes mellitus

ICD-10-GM: E11.-; GONR: 32060 32061 32062 32063 (laboratory examinations)

T2D: Hypertension, nephropathy and ACE-inhibitor or AT1-blocker

Process indicators

Persons with type 2 diabetes mellitus, diabetic nephropathy and hypertension treated with ACE inhibitor or AT1-blocker

Persons with type 2 diabetes mellitus, diabetic nephropathy and hypertension

ICD-10-GM: E11.- E11.2 N08.3 N18.1 N18.2 N18.3 N18.4 N18.5 Z49.1; ATC: C09

T2D: Serum-creatinine

Process indicators

check of serum creatinine

Persons with type 2 diabetes mellitus

ICD-10-GM: E11.-; GONR: 32066 32067.

Osteoarthritis: Prevalence

Morbidity

Persons with osteoarthritis

All persons

ICD-10-GM: M15.- M16.- M17.- M18.- M19.-

Osteoporosis: Prevalence

Morbidity

Persons with osteoporosis

All persons

ICD-10-GM: M80.- M81.- M82.-

Prevention: Influenza vaccination

Process indicators

Persons over 65 years with influenza vaccination

Persons over 65 years

ICD-10-GM: Z25.1

Prevention: Mammography

Process indicators

Women between 50 and 70 years with mammography according to German cancer screening guidelines

Women between 50 and 70 years

GONR: 01750, Exclusion of women with ICD-10-GM C50.- (breast cancer) in the denominator

Prevention: Faecal occult blood test

Process indicators

Persons over 65 years with faecal occult blood test every 2 years according to German cancer screening guidelines

Persons over 65 years

GONR: 01734. Exclusion of persons with ICD-10-GM C18.- C19.- C20.- (colo-rectal cancer) in the denominator

Prevention: Men's cancer screening

Process indicators

Men over 18 years with cancer screening according to German cancer screening guidelines

Men over 18 years

GONR: 01731, Exclusion of persons with ICD-10-GM C60.- C61.- C62.- C63.- (malignant neoplasms of male genital organs) in the denominator

Prevention: Skin-cancer screening

Process indicators

Persons with screening for skin cancer according to German cancer screening guidelines

All persons

GONR: 01745, Exclusion of persons with ICD-10-GM C43.- C44.- (melanoma and other malignant neoplasms of skin) in the denominator

Depression: Prevalence

Morbidity

Persons with diagnosed depression

All persons

ICD-10-GM: F32.- F33.- F34.1

Depression: Anti-depressive pharmacotherapy

Process indicators

Persons with diagnosed depression and anti-depressive pharmacotherapy

All persons with diagnosed depression

ICD-10-GM: F32.- F33.- F34.1; ATC: N06AA N06AB N06AF N06AG N06AX N05AN01 (anti-depressive pharmacotherapy)