Comparison of claims based vs electronic health record contraceptive performance measures
Awarded 2018
Complex Family Planning Fellowship Research
Surya Cooper, MD, MPH
Columbia University

Objectives: To compare contraceptive provision 2016-2018 across ambulatory care clinics at New York Presbyterian Hospital(NYPH) quarterly and by clinic specialty using NQF-endorsed contraceptive care measures.
Methods: We evaluated contraception provision across 31 clinics at the NYPH Ambulatory Clinic Network using the NQF-endorsed contraceptive care measures. We evaluated women ages 15 to 44 at risk of unintended pregnancy using claims-based data. We assessed most- and moderately-effective contraceptive provision and LARC provision by clinic specialty: OB/GYN, Family Medicine, Pediatrics, Internal Medicine and School-Based clinics compared to Family Planning Clinic.  We calculated the measures annually and quarterly.
Results: We included 97,487 patient visits from 2016 to 2018. Most- and moderately-effective contraception provision was highest in the Family Planning Clinic (60% of 32,934 visits) followed by OB/GYN (47% of 36,919 visits), School-based clinics (39% of 5113 visits), Family Medicine (34% of 7894 visits), Pediatrics (27% of 2868 visits), then Internal Medicine (19% of 11,750 visits). LARC provision was also highest in the Family Planning clinic (18%) followed by School-based (9%), OB/GYN and Pediatrics (2%). Family Medicine (1%) and Internal Medicine 0%. Adjusting for clinic location and patient age distribution did not change results. Overall most- and moderately-effective contraception provision was 47% of 33,374 visits in 2016, 45% of 33,020 visits in 2017 and 41% of 31,084 visits in 2018. This trend persisted in the quarterly data. LARC provision remained stable.
Conclusion: The contraceptive care measures are a feasible tool to measure contraceptive provision and identify trends over time and can be used to assess quality improvement project effectiveness.