What is the reasoning for these exclusions

Reference no: EM133242872

Case: Diabetes Quality Reporting Measures

HEDIS inclusion criteria is as follows: adults between the ages of 18-75 with type 1 or type 2 diabetes in the measurement year [1]. Through further research, I came across a Comprehensive Diabetes Care tip sheet for BlueCross BlueShield of Illinois that details the exclusion criteria.These excluded the following members who were: under hospital care in the measurement year, provided dementia medication, age 66+ with frailty and advanced illness in the measurement year, age 66+ Medicare members enrolled in an Institutional Special Needs Plan or living in an institution, and diagnosed with polycystic ovarian syndrome, gestational diabetes, or steroid-induced diabetes in the measurement year or year before but were not diagnosed with diabetes.

Problem: What is the reasoning for these exclusions and are there aspects of the measures' inclusion/exclusion criteria that might affect whether the measure is capturing relevant health disparities?

Reference no: EM133242872

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