Assessment of acute otitis externa and otitis media with effusion performance measures in otolaryngology practices.

Abstract

To evaluate the acute otitis externa and otitis media with effusion performance measure sets in a clinical setting and provide preliminary data on measure compliance. Quality improvement study. Convenience sampling (N = 84) was performed at five sites of ENT and Allergy Associates, LLC. Physicians reported prescribing topical antibiotic preparations and assessing for auricular or periauricular pain in 98% of acute otitis externa cases (N = 55). In addition, 87% did not prescribe systemic antimicrobials. Pneumatic otoscopy was used by 76% of physicians as a method for otitis media with effusion diagnosis and 10% administered a hearing test within 6 months before tympanostomy tube placement (N = 29). Furthermore, as recommended, 86% did not prescribe decongestants or antihistamines whereas 93% and 90% did not prescribe antimicrobials or systemic steroids, respectively. Although compliance in this study was generally high across both measure sets, actual use of the face sheet forms for appropriate patients was lower than the 80% reporting mandate by the Centers for Medicare and Medicaid Services that allows physicians to receive the monetary bonus. Incentive-based reporting should be continuously investigated to assess challenges for evaluating current measures.