Tracking clinical preventive service use - A comparison of the health planemployer data and information set with the behavioral risk factor surveillance system

BACKGROUND. There is a need for meaningful and accurate ways of tracking pr eventive service delivery among different sectors of the US population. OBJECTIVES. To compare methodologies of and clinical preventive service use estimates obtained from 2 data sets: the Health Plan Employer Data and Inf ormation Set (HEDIS 3.0) and the Behavioral Risk Factor Surveillance System (BRFSS). METHODS. HEDIS used a combination of mailed-survey, administrative, and med ical-record data to measure preventive service use among commercial enrolle es of 320 HMOs in 42 states during 1996. BRFSS data are from insured respon dents (excluding those reporting Medicare or Medicaid coverage) to a random -digit-dialed telephone survey conducted in the same 42 states during 1996. RESULTS. The median state-specific mammography, Papanicolaou smear, and ret inal examination rates reported by HEDIS were consistently and substantiall y lower than those reported by BRFSS. For mammography, the median HEDIS rat e was 72.4%, compared with 81.1% for BRFSS. For Papanicolaou smear and reti nal examinations, HEDIS rates were 72.7% and 40.8%, respectively, compared with 91.2% and 61.6% for BRFSS. The median state rates of advice to quit sm oking reported by HEDIS were similar to those for BRFSS: 62.1% versus 62.2% , respectively. For each measure, the absolute difference between HEDIS and BRFSS rates varied substantially both within a state and between states. CONCLUSIONS. It does not appear that the BRFSS and HEDIS data can be compar ed directly to accurately track progress toward national preventive health objectives. This study I highlights some of the problems with comparing the se data and possible means for addressing the discrepancies.