Measures for Respiratory Conditions

Last update: October 16, 2020

The Centers for Disease Control and Prevention (CDC) estimate that more than 100 million antibiotic prescriptions are written each year in the ambulatory care setting. Inappropriate antibiotic use will promote resistance. UnitedHealthcare would like to emphasize to care providers the appropriate use of antibiotics in children and adults with upper respiratory tract infections. The following are two measures that are counted in the yearly Healthcare Effectiveness Data and Information Set (HEDIS®) audit that addresses this health and treatment concern:

  • The HEDIS® measure, URI, Appropriate Treatment for Children with Upper Respiratory Infection, counts the percentage of children, ages 3 months – 18 years, who were given a diagnosis of upper respiratory infection (URI) and were not given an antibiotic prescription. The measure is reported as an inverted rate. A higher rate indicates appropriate treatment of children with URI (i.e., the proportion for whom antibiotics were not prescribed). The CDC reports that studies show the common cold resolves without antibiotic treatment and treatment with an antibiotic doesn’t shorten the duration of illness or prevent bacterial rhinosinusitis.
  • The HEDIS® measure, AAB (Avoidance of Antibiotic Treatment) in Adults with Acute Bronchitis, counts the percentage of adults, ages 18-64, with a diagnosis of acute bronchitis who were not given an antibiotic prescription. This measure is also reported as an inverted rate. A higher rate indicates the appropriate treatment of adults with acute bronchitis (i.e., the proportion for whom antibiotics were not prescribed). The CDC recommends against the use of antibiotics for acute bronchitis, as it often occurs after a URI like a cold and is usually caused by a viral infection.

HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).