Reliability evidence for contraceptive provision measures
Awarded 2020
Complex Family Planning Fellowship Research
Nancy Fang, MD
Columbia University

Background: Quality assurance and improvement in healthcare relies on performance measurement. Up until recently, there were no performance measures related to reproductive health and contraceptive provision. The Office of Population Affairs (OPA) developed and validated claims-based performance measures for contraceptive care, aimed at addressing unintended pregnancy. In 2016, the National Quality Forum (NQF) endorsed these measures, which aligned with the Institute of Medicine’s (IOM) recommended core metrics.
New York Presbyterian Hospital (NYPH) established baseline rates of claims-based contraceptive provision for the women who made nearly 97,000 visits to 31 primary care clinics within its Ambulatory Care Network (ACN) between 2016 and 2018. Contraception provision of most- and moderately-effective methods ranged from 19-60% and was highest in the Family Planning Clinic. To maintain NQF endorsement, OPA must provide current scientific evidence of reliability every three years.
1. Assess the reliability of performance measures with the training and technical support of the Far Harbor team (OPA’s contracted statistical support) using the 2016-2018 NYPH ACN database.
2. Create a report for the reliability analyses for the NQF application.
3. Develop and refine a scientific presentation and manuscript of the reliability analyses in the context of contraceptive performance measures.
Methods: Using the 2016-2018 NYPH ACN numerator and denominator counts, we will calculate reliability of the NQF contraceptive measures. We will use customized R and Hierarchical Linear Modeling (HLM) programs to assess reliability at the levels of location and specialty.
Potential Impact/Results: To help strengthen contraceptive care delivery, performance measures may be used to improve the quality of care through quality improvement processes at the patient/provider and healthcare system level or publicly reported for accountability by consumers and payers. Proof of reliability will strengthen the utility of the performance measures and ultimately improve patient care.