Pregnancy testing in XXXX of reproductive age in US emergency departments, 2002 to 2006: assessment of a national quality measure.

@entity1 @entity1479 @entity341 @entity5849 @entity490
STUDY OBJECTIVE: We assess performance and explore definitions for a new @entity341 ( @entity341 ) quality measure: the proportion of @entity1 aged 14 to 50 years who have @entity490 and receive pregnancy testing (aimed at detecting @entity5849 ). METHODS: We analyzed data from the National Hospital Ambulatory Medical Care Survey (NHAMCS) (2002 to 2006) to test trends and predictors of the new measure, using both restrictive and broad definitions from the International Classification of Diseases, Ninth Revision (ICD-9) and reason-for-visit codes, and determine the proportion of @entity1 with @entity5849 who had undergone pregnancy testing. For comparison, we conducted a detailed chart review in 4 US hospitals among @entity1 who visited the @entity341 in 2006. RESULTS: Using a @entity1479 for inclusion in NHAMCS, 2.13 million @entity1 aged 14 to 50 years with @entity490 visited an @entity341 annually between 2002 and 2006. Of those, 33.0% (95% confidence interval [CI] 30.5% to 35.5%) received pregnancy testing. Testing rates were materially stable, regardless of the definition used (broad or restrictive ICD-9 or reason-for-visit code). Among @entity1 with an ICD-9 diagnosis of @entity5849 , 55.6% (95% CI 43.7% to 67.6%) had a documented pregnancy test. In the chart review, among 200 @entity1 aged 14 to 50 years and with @entity490 , 89.4% (95% CI 85.0% to 94.0%) were eligible for the measure; of those, 93.9% (95% CI 90.3% to 97.4%) received testing. CONCLUSION: Analysis of national @entity341 survey data demonstrated a large performance gap for a new pregnancy testing quality measure, whereas focused chart review at 4 sites showed a smaller gap. Given these discrepancies, additional study is recommended before the widespread implementation of the pregnancy testing measure as an assessment of @entity341 performance.
