New clinical performance measures for contraceptive care: their importance to healthcare quality

Objectives: The National Quality Forum (NQF) recently endorsed the first clinical performance measures for contraceptive care. We present data demonstrating that the measures meet the NQF's criterion "importance to measure and report." Study design: We summarized national contraceptive care initiatives, epidemiologic data documenting the reproductive health burden and the scientific literature examining the association between contraceptive use and unintended pregnancy. In addition, we analyzed contraceptive use data from the National Survey of Family Growth (2013-2015) and the Pregnancy Risk Assessment Monitoring System (2012-2013). Results: Five Federal agencies lead national initiatives, and two Institute of Medicine reports highlight the centrality of reproductive health outcomes for the health of women and infants. Two literature reviews demonstrate that the type of contraception used is associated with risk of unintended pregnancy. Fifty-three percent of adolescents (15-19 years) and 40% of adult women (20-44 years) at risk of unintended pregnancy are not using a most or moderately effective contraceptive method; in the postpartum period, one third of adolescents (<= 19years) and 44% of adult women (>= 20 years) are not using these methods. Conclusions: The new contraceptive care measures meet the NQF criterion for "importance to measure and report." The measures are based on evidence that contraceptive use is associated with reproductive health outcomes, and there is a substantial performance gap in the use of most and moderately effective methods. Published by Elsevier Inc.