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DRAFT 2008 UDS Reporting Manual
 
 

Appendix C: Sampling Methodology for Manual Chart Reviews

INTRODUCTION

NOTE: For each measure, Centers have the option of reporting on their entire patient population as a universe. This is an optimal method if the data for the measure are collected electronically and can be reported without manual intervention.

The methodology set forth in this appendix applies to each of the performance measures requiring a sampling process. These measures are the following.

 

Reported in Table 6B:

  • Childhood Immunization Rate – percent of patients 2 years of age with up-to-date immunizations.
  • PAP Test Rate – percent of female patients aged 18 – 64 who have had a PAP test during the measurement year or during the previous two calendar years.

Reported in Table 7

  • HbA1c Levels – Percent of diabetic patients with HbA1c levels
    • Less than or equal to 7%
    • Greater than 7% and less than or equal to 9%
    • Greater than 9%
  • Hypertension – percent of patients 18 years of age and older with hypertension whose latest blood pressure did not exceed 140/90.

METHODOLOGY

For each measure, perform each of the following steps.

 

STEP 1: Identify the patient population to be sampled (the universe):

Define the universe for each condition. Create a list and number each member of the patient population for the entire health center grantee.

 

STEP 2: Determine the sample size for manual chart review:

The number of charts selected for manual chart review will be the lesser of 70 charts or all patients who meet the criteria.

 

STEP 3: Calculate the sample interval

Divide the patient population by the sample size to obtain the sample interval.

 

 Sample Interval Size = Population size (N)/ Sample size (n)

 

 

STEP 4: Conduct systematic sample

Random Start:

Randomly pick a patient from the first sampling interval. For example, if the sampling interval is 10, the first sampling interval includes patients no.1 through no.10. Randomly select one patient from this interval.

 

Then, select every nth patient based on the sampling interval until you reach the desired sample size. In our example, if the first patient selected is number 8, and the sampling interval is 10, then the remaining patients to be selected are no.18, 28, 38, etc. 

 

Reselection Criteria:

If a selected chart is one for a patient that is not a member of your patient panel or is a patient that should be excluded from the sample then you will need to re-select another patient chart. Go to the next chart; continue selecting the next chart until a chart for an eligible patient is selected. Resume selection using the next chart you had pre-selected for the sample.. (If you run out of charts, continue your count back at the beginning of the universe.)

 

 

[1]. Note that in previous documents, application guidance and other materials, HRSA has made reference to the School Based Health Center (SBHC) Program. Section 330 of the PHS Act does not include specific authorization for a SBHC Program. HRSA no longer identifies it as a separate funding pool, but does continue to collect separate information about programs which historically served this unique population in the UDS.

[2] Note that this is a minor change from prior years. In prior years patients who delivered in early days of the new year but had had their last prenatal care visit in the prior year were not counted. This new table counts those women as well. Thus, a woman whose last prenatal care visit was December 28th 2008 who delivered on January 3rd 2009 will be reported on the 2009 table.

[3] Note that this is a change from prior years. In prior years only those patients who had also had a prenatal care visit in the reporting period were counted, and some patients who delivered in the first few days of the new year were left out. This new table counts those women as well. Thus, a woman whose last prenatal care visit was December 28th of the prior year and who delivered on January 3rd of the reporting period is reported on in this table.