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CKD-4.2 Data Details

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CKD-4.2 Increase the proportion of persons with type 1 or type 2 diabetes and chronic kidney disease who receive medical evaluation with serum creatinine, microalbuminuria, A1c, lipids, and eye examinations

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

Data Source: 
United States Renal Data System
Changed Since the Healthy People 2020 Launch: 
Yes
Measure: 
percent
Baseline (Year): 
23.0 (2007)
Target: 
25.3
Target-Setting Method: 
10 percent improvement
Numerator: 

Number of persons aged 65 years and over with type 1 or type 2 diabetes and chronic kidney disease who receive medical evaluation with serum creatinine, microalbuminuria, A1c, lipids, and eye examinations

Denominator: 

Number of persons aged 65 years and over with type 1 or type 2 diabetes and chronic kidney disease

Comparable Healthy People 2010 Objective: 
Adapted from HP2010 objective
Data Collection Frequency: 
Annual
Methodology Notes: 

    The data to track this objective come from the United States Renal Data System (USRDS) 5% Medicare sample. The methods and codes used to determine rates of glycosylated hemoglobin (A1c) testing and eye examinations are taken from the Health Effectiveness and Data Information Set (HEDIS) 2008 specifications. HEDIS 2008, a program of the National Committee for Quality Assurance (NCQA), is used to monitor the performance of managed health care plans.

    CPT codes 83036 and 83037 are used to identify A1c testing. Codes used to identify diabetic eye examinations are as follows: CPT codes, 92002, 92004, 92012, 92014, 92018, 92019, 92225, 92226, 92230, 92235, 92240, 92250, 92260, 67101, 67105, 67107, 67108, 67110, 67112, 67141, 67145, 67208, 67210, 67218, 67227, 67228, 67028, 67030, 67031, 67036, 67038, 67039, 67041, 67042, 67043, 67113, 67121, 67221, 67228, S0625, S0620, S0621, and S3000; ICD-9-CM procedure codes, 14.1–14.5, 14.9, 95.02, 95.03, 95.04, 95.11, 95.12, and 95.16; and ICD-9-CM diagnosis code V72.0.

    The USRDS data, data collection procedures, calculation methods, and other technical information are included in the USRDS Annual Data Report.

Changes Between HP2010 and HP2020: 
This objective differs from Healthy People 2010 objective 4-8a which measured medical evaluation among people with diabetes and chronic kidney disease (CKD). The recommendations for medical evaluation of persons with type 1 or type 2 diabetes and CKD have been updated and currently include serum creatinine and microalbuminuria tests in addition to A1c, lipids, and eye examinations. Consequently, data for this objective are not comparable with data for the Healthy People 2010 objective.

Revision History

Any change to the objective text, baseline, target, target-setting method or data source since the Healthy People 2020 launch.

Description of Changes Since the Healthy People 2020 Launch: 
In 2013, the original baseline was revised from 23.1 to 23.0 percent due to USRDS rates re-estimation. There is some lag in reporting new cases of ESRD. Therefore, each year’s Annual Data Report includes re-estimates of earlier year rates. For more information see the USRDS Annual Data Reports. The target was adjusted from 25.4 to 25.3 percent to reflect the revised baseline using the original target-setting method.

References

Additional resources about the objective

  1. More information on the analytic methods used to calculate these rates can be found in Appendix A of the USRDS Annual Data Report Atlas.

  2. U.S. Renal Data System, USRDS 2012 Annual Data Report: Atlas of Chronic Kidney Disease and End-Stage Renal Disease in the United States, National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, 2012