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Measure Name | Pregnant Women (PW): % of MSIS IDs in ELIGIBILITY-GROUP = 05, 53, 67 or 68 (PW groups) with Age 13-64 |
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File Type | ELG |
Measure ID | EL-3-007-4 |
Measure Type | Non-Claims Percentage |
Content area | ELG |
Validation Type | Inferential |
---|
Measure Priority | Medium |
---|---|
Focus Area | N/A |
Category | Beneficiary eligibility |
Claim Type | N/A |
---|---|
Adjustment Type | N/A |
Crossover Type | N/A |
Minimum | 0.95 |
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Maximum | 1 |
TA Minimun | 0.85 |
TA Maximum | 1 |
Longitudinal Threshold | N/A |
For TA
(for including in compliance training) |
TA- Inferential |
For TA
(Longitudinal) |
No |
DD Data Element | MSIS-IDENTIFICATION-NUM • ELIGIBILITY-GROUP |
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DD Data Element Number | ELG082 • ELG087 |
Annotation | Calculate the percentage of pregnant women that are between the ages of 13 and 64 |
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Specification |
STEP 1: Enrolled on the last day of DQ report month Define the eligible population from segment ENROLLMENT-TIME-SPAN-ELG00021 by keeping active records that satisfy the following criteria: 1. ENROLLMENT-EFF-DATE <= last day of the DQ report month 2. ENROLLMENT-END-DATE >= last day of the DQ report month OR missing 3. MSIS-IDENTIFICATION-NUM is not missing STEP 2: Eligibility determinants on the last day of DQ report month Using the MSIS IDs that meet the criteria from STEP 1, join to segment ELIGIBILITY-DETERMINANTS-ELG00005 by keeping records that satisfy the following criteria: 1. PRIMARY-ELIGIBILITY-GROUP-IND = 1 2a. ELIGIBILITY-DETERMINANT-EFF-DATE <= last day of the DQ report month 3a. ELIGIBILITY-DETERMINANT-END-DATE >= last day of the DQ report month OR missing OR 2b. ELIGIBILITY-DETERMINANT-EFF-DATE is missing 3b. ELIGIBILITY-DETERMINANT-END-DATE is missing STEP 3: Unique Pregnant Women Of the MSIS IDs that meet the criteria from STEP 2, select pregnant women: 1. ELIGIBILITY-GROUP = "05" or "53" or "67" or "68" 2. Remove any duplicates, so each MSIS ID only appears once. STEP 4: Primary demographics on the last day of DQ report month Using the MSIS IDs that meet the criteria from STEP 3, join to segment PRIMARY-DEMOGRAPHICS-ELG00002 by keeping records that satisfy the following criteria: 1a. PRIMARY-DEMOGRAPHIC-ELEMENT-EFF-DATE <= last day of the DQ report month 2a. PRIMARY-DEMOGRAPHIC-ELEMENT-END-DATE >= last day of the DQ report month OR missing OR 1b. PRIMARY-DEMOGRAPHIC-ELEMENT-EFF-DATE is missing 2b. PRIMARY-DEMOGRAPHIC-ELEMENT-END-DATE is missing STEP 5: Calculate Age Of the MSIS IDs that meet the criteria from STEP 4, calculate age: 1a. If DATE-OF-DEATH is non-missing and occurs before the last day of the DQ report month, Age is equal to the years between DATE-OF-DEATH and DATE-OF-BIRTH. 1b. Otherwise, Age is equal to the years between the last day of the DQ report month and DATE-OF-BIRTH. STEP 6: Pregnant Women Aged 13-64 MERGE MSIS IDs from STEP 3 and 5 and only keep the matches and make sure there is still only one observation per MSIS ID. Then, select women with ages between 13 and 64: Age >= 13 and Age <=64. STEP 7: Calculate percentage for measure DIVIDE the count of MSIS IDs from STEP 6 by the count of MSIS IDs from STEP 3 |