The Appropriate Treatment for Upper Respiratory Infection (URI) measure assesses whether members 3 months of age and older with a diagnosis of upper respiratory infection were not dispensed an antibiotic prescription. The measure includes patients enrolled in commercial, Medicaid, and Medicare health plans.
The numerator of the measure includes the number of dispensed prescriptions for an antibiotic medication on or 3 days after the Episode Date.
Denominator
1.15 Denominator
Episodes for members 3 months of age and older as of July 1 of the year prior to the measurement year who had an outpatient, telephone, e-visit or virtual check-in, an observation visit or ED encounter with a diagnosis of upper respiratory infection (URI) during the intake period (July 1st of the year prior to the measurement year to June 30th of the measurement year).
Exclusions
Exclusions
Exclude visits that result in an inpatient stay.
Exclude Episode Dates when the member had a claim/encounter with any diagnosis for a comorbid condition during the 12 months prior to or on the Episode Date.
Exclude Episode Dates where a new or refill prescription for an antibiotic medication was filled 30 days prior to the Episode Date or was active on the Episode Date.
Exclude Episode Dates where the patient had a claim/encounter with a competing diagnosis on or three days after the Episode Date.
Measure Record
Most Recent Endorsement Activity
Endorsed Primary Care and Chronic Illness Fall Cycle 2020
Public Comments