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Cervical Cancer Screening (20-29)

Basic Facts

Stage of development

Implemented

Potential or current usage

This measure has been part of the PHO Performance Programme's National Indicator Set since 1 January 2011 and is used to measure how many women aged 20 to 69 years have had a cervical smear within the last 3 years.

Brief overview of the measure

General description

This measure focuses on the number of women aged between 20 and 69 years who have had a cervical screen within the last 3 years.

Rationale for selection

Early detection and treatment of cervical cancer and other abnormalities lowers the rate of death from cervical cancer. The national cervical screening programme recommends women have three yearly cervical screens from the ages 20 to 69 years. This screening interval may alter if a smear result is abnormal.

Domain(s) of quality

Effectiveness, Efficiency

Application and interpretation of the measure

Stated intent of the measure

Ensuring appropriate follow up of patients that are eligible for a cervical screen.

Caveats - Considerations

This measure, when reported through the PHO Performance Programme has had a hysterectomy algorithm applied - the algorithm has been developed by the National Screening Unit based on the number of hysterectomies provided from 1987 through to 1992 by age. The algorithm is as follows: Age Group Adjustment Factor (multiplied by women in age group) 20 - 24 years 1 25 - 29 years .996 30 - 34 years .980 35 - 39 years .944 40 - 44 years .886 45 - 49 years .819 50 - 54 years .769 55 - 59 years .743 60 - 64 years .726 65 - 69 years .708

Level of health care delivery/setting

This measure is currently reported by the PHO Performance Programme to PHO level although use of this measure to monitor practice and patient level performance is also possible.

Target population

All women aged 20 to 69 years All women aged 20 to 69 years within the high need population (identified as Māori, Pacific Island and/or Decile 9 or 10)

Stratification by vulnerable populations

The PHO Performance Programme currently uses this measure to monitor at both a total PHO enrolled population level (all PHO enrolled eligible patients) and a high need PHO enrolled population level (whereby high need is identified as Māori, Pacific Island and/or Decile 9 or 10)

Associated incentives

This measure is currently funded through the PHO Performance Programme both at a total population level and a high need level.

Calculation of the measure

Output of calculation

Percentage of women aged 20 to 69 years who have had a cervical screen in the past 3 years.

Numerator description

The number of women enrolled with a PHO aged 20 to 69 years who have had a cervical screen in the past 3 years.

Denominator description

The number of women enrolled with a PHO aged 20 to 69 years (adjusted for the expected number of women who have had a hysterectomy).

Time period

3 years

Criteria/standard for optimal performance

Every practice within a PHO should have a process in place for identifying / recalling women that are due for a cervical screen and following through to ensure the service has taken place. The PHO Performance Programme goal is: 75% or more of the PHO’s target population have had a cervical screen within 3 years.

Data source

PHO patient enrolment registers and the National Screening Unit's cervical screening register.

Method of extraction

The link below will take you to the document that defines how the measure is calculated - see 'Cervical Cancer Screening Coverage' section of the Indicator Definitions for PHOs document. http://www.dhbnz.org.nz/Site/SIG/pho/Operational-Documents.aspx

Key issues and challenges for data management

Many women who have had a hysterectomy do not need a cervical smear. The Programme does apply an adjustment calculation to allow for women with hysterectomies, based on the national rate. However since the rate of hysterectomies within each PHO may vary, this adjustment may not always be correct at the PHO level. Some patients choose to ‘opt off’ the national screening programme’s register (which means that although they have had a cervical screen, they will not be ‘counted’ by the Programme).

Appraisal of the measure

Development approach

Initial selection of this indicator in 2005 was done by the Ministry of Healh using a consensus process. Since then the indicator has been reviewed and refined in consultation with the PHO Performance Programme Advisory Group - refer to link for current membership list: http://www.dhbnz.org.nz/Site/SIG/pho/PHO/Membership-List.aspx All changes have been endorsed by the PHO Performance Programme Governance Group - refer to link for current membership list: http://www.dhbnz.org.nz/Site/SIG/pho/PHO/Governance-Group-Membership-List.aspx

Other items

Owner detail

Reference number

858

Date of entry to library

2012-05-31 13:08:50

Owner (Organisation name)

PHO Performance Programme

Owner (Email contact)

phoperformanceprogramme@dhbnz.org.nz

Creator (Organisation name)

PHO Performance Programme

Creator (Email contact)

phoperformanceprogramme@dhbnz.org.nz