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Panel session III-Measuring results: Understanding and implementing tobacco measures
An overview of tobacco measures
  1. Ronald M Davis
  1. Center for Health Promotion and Disease Prevention, Henry Ford Health System, One Ford Place, 5C, Detroit, Michigan 48202–3450, USA;rdavis1@hfhs.org

https://doi.org/10.1136/tc.7.suppl_1.S36

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    In this panel session I will be making an introductory presentation, after which we will hear from Tim McAfee and Jodi Jessen. After all of the presenters have been heard from, we will address “questions for the future”.

    In my talk I would like to review: (a) the value of performance measurement and the different ways in which performance measurement can serve our purposes; (b) the different tobacco measures that have been developed or proposed, including those proposed by the Center for the Advancement of Health, those being used in the Health Plan Employer Data and Information Set (HEDIS), and those proposed by the Foundation for Accountability (FACCT); (c) results of the HEDIS tobacco measure in the 1996 reporting set; and (d) problems or potential problems with the HEDIS measures.

    The value of performance measurement

    Performance measures can help us monitor change over time for an individual health plan. They can help us observe differences across health plans and disparities within health plans—for example, between commercial members and Medicaid or Medicare members. Performance measurement allows us to identify providers with the best and worst performance—at the level of the clinic and the level of individual providers. And finally it permits us to assess the effectiveness of interventions.

    Tobacco measures

    Once we have decided that we want to measure performance, the question is, how do we do it? As the cartoon in figure 1 shows, we have to determine whether we are making any impact. We have to decide which measures to use. Which measures should we use for these howling wolves? Should it be how high the moon rises in the evening sky, or how brightly the moon shines, or how much the stars are flickering? Those are the kinds of questions that we struggle to answer when we try to address tobacco in managed care.

    Figure 1

    Are …

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