In 1999 and 2000, the Kaiser Foundation Hospitals, Kaiser Foundation Research Institute, Portland, Ore., developed and tested new measures to assess the frequency, extent, and quality of tobacco treatment services delivered to patients during routine doctor visits.

These questions were then recommended to the National Committee on Quality Assurance (NCQA) for inclusion in future surveys conducted by the Health Plan Employer Data and Information Set (HEDIS) Tobacco Measure, a set of performance measures produced by NCQA.

When the grant was made, HEDIS included a question asking smokers if, during routine doctor visits, their physicians had advised them to quit smoking. This question helped draw attention to how health care plans address tobacco use and addiction, but it offered little incentive for them to provide more effective assistance and follow-up to patients.

Key Results

• Researchers recommended that NCQA incorporate new questions into future HEDIS surveys. They suggested that the new questions explore whether physicians assess patient motivation to stop smoking and whether physicians offer specific types of assistance or follow-up, such as suggesting particular smoking cessation programs.
• Researchers recommended that the survey retain questions assessing the frequency of patient visits to health care professionals, the number of visits during which patients were advised to quit smoking, and the frequency with which smoking was discussed.

Funding
The Robert Wood Johnson Foundation (RWJF) supported the project with a grant of $178,500 between September 1999 and October 2000.