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Appropriate Treatment for Children With Upper Respiratory Infection (URI)

CBE ID
0069
Endorsement Status
1.0 New or Maintenance
1.1 Measure Structure
Previous Endorsement Cycle
Is Under Review
No
Next Maintenance Cycle
Spring 2027
1.6 Measure Description

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.

    Measure Specs
      General Information
      1.7 Measure Type
      1.3 Electronic Clinical Quality Measure (eCQM)
      1.8 Level of Analysis
      1.20 Types of Data Sources
      1.14 Numerator

      The numerator of the measure includes the number of dispensed prescriptions for an antibiotic medication on or 3 days after the Episode Date.

      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

      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.

      Most Recent Endorsement Activity
      Endorsed Primary Care and Chronic Illness Fall Cycle 2020
      Initial Endorsement
      Last Updated
      Steward Organization
      National Committee for Quality Assurance
      Steward POC email
      Steward Organization Copyright

      © 2020 by the National Committee for Quality Assurance
      1100 13th Street, NW, Third Floor
      Washington, DC 20005

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