FROM: Theodore O. Will, Chief Executive Officer
DATE: Aug 20, 1999
SUBJECT: Helicobacter Pylori Diagnosis and Treatment for New York State Medicare Patients Hospitalized for Peptic Ulcer Disease
IPRO CONTACTS:
Marguerite Shaffer, R.N., Director Downstate, Improvement Strategies QI - Ext. 356 and Barbara Shields, R.N., C.P.H.Q., Upstate Director, Improvement Strategies/QI (1-800-233-0360)
Enclosed please find the report entitled "Helicobacter Pylori Diagnosis and Treatment for New York State Medicare Patients Hospitalized for Peptic Ulcer Disease: Point Prevalence Trends for 1995, 1997 and 1998."
This report shows improving trends in diagnostic testing for a leading cause of peptic ulcer disease, Helicobacter pylori (HP). Unfortunately the timely treatment of patients with a confirmed HP diagnosis has not changed significantly. This may be, in part, due to physicians= desire to treat patients as outpatients, a delay in therapy that is unnecessary and also, in part, due to hospital delays in getting HP test results on the medical record prior to patient discharge.
These time series data show only about one-half of hospitalized Medicare patients with confirmed peptic ulcer disease who have been tested for HP are HP positive. Testing for HP prior to treatment is important. Hospitals need to evaluate their HP test result reporting mechanisms and physicians need to continue to improve their test ordering for HP in peptic ulcer disease patients.
Should you have any questions about this project or report, please feel free to call one of the above-mentioned contacts.
Peptic ulcer disease (PUD) is a major cause of chronic abdominal pain and can cause major morbidity and death. Research conducted over the past ten years supports the conclusion that Helicobacter pylori (HP) is an etiologic agent. Consensus guidelines published by the National Institutes of Health and the American College of Gastroenterology support the identification and treatment of HP with combinations of selected antibiotics, histamine antagonists and gastric acid pump inhibitors. Using 1995 hospital claims data as a baseline, IPRO implemented in 1997 a Health Care Quality Improvement Project (HCQIP) in HP diagnosis and treatment for New York State Medicare patients. HCQIP interventions included hospital-specific meetings and mailings regarding PUD and HP, a state-wide telephone conference series to New York State hospitals, and mailings to beneficiaries regarding PUD diagnosis and treatment.