In 1999 Congress mandated that the Agency for Healthcare Research and Quality (AHRQ) report annually to the Nation about health care disparities. An interagency workgroup developed a preliminary measure set for the National Healthcare Disparities Report (NHDR). Select for Background on the original NHDR measures development process.
The NHDR and the National Healthcare Quality Report (NHQR) were designed and planned as companion reports. To ensure uniformity, these two reports use identical measures of quality of health care to the extent possible with available data. (Because of data unavailability, examining disparities in some of these quality measures was not possible in the first NHDR.)
In addition to examining disparities in quality of health care, the NHDR also examines disparities in access to health care. To view the NHDR access measures, select for:
Getting Into the Health Care System
Health Insurance Coverage
/ Usual Source of Care / Patient
Perceptions of
Need
Getting Care Within the
System
Difficulty Getting Care
Patient Perceptions of Their Care
Patient-Provider Communication
/ Patient-Provider Relationship /
Cultural Competency / Health
Information
Health Care Utilization
Overall Utilization / Care in Doctors' Offices and Hospital Outpatient Departments / Referred Care / Mental Health & Substance Abuse Treatment / HIV Care / Emergency Care / Inpatient Care / Chronic Care
Topic | Measure | National Databasea |
---|---|---|
Health Insurance Coverage | People under 65 with health insuranceb | NHIS |
People under 65 with any private insurance | NHIS | |
People 65 and over with any private insurance | NHIS | |
People under 65 with public insurance only | NHIS | |
People uninsured all year | MEPS | |
People with any period of public insurance during a year | MEPS | |
People with any period of uninsurance during a year | MEPS | |
Usual Source of Care | People who have a specific source of ongoing careb | NHIS |
People in fair or poor health who have a specific source of ongoing care | NHIS | |
People with hospital, emergency room, or clinic as a source of ongoing care | NHIS | |
People without a usual source of care who indicate a financial or insurance reason for not having a source of care | MEPS | |
People who have a usual primary care providerb | MEPS | |
Adults with community health center as usual source of care | Commonwealth | |
Adults who report very little or no choice in source of care | Commonwealth | |
Adults who have not had their regular doctor for more than 5 years | Commonwealth | |
Patient Perceptions of Need | Families that experience difficulties or delays in obtaining health care or do not receive needed careb | MEPS |
Families that experience difficulties or delays in obtaining health care due to financial or insurance reasons | MEPS | |
Families that did not receive a doctor's care or prescription medications because the family needed the money | MEPS | |
Families not very satisfied that they can get health care if they need it | MEPS | |
Adults who can always get appointments for routine care as soon as wanted | MEPS | |
Adults who can always get care for illness or injury as soon as wanted | MEPS |
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Topic | Measure | National Databasea |
---|---|---|
Difficulty Getting Care | People who usually use public transportation to get to provider | MEPS |
People with provider who has office hours at night or on weekends | MEPS | |
People with difficulty getting appointments with provider on short notice | MEPS | |
People with difficulty contacting provider over the telephone | MEPS | |
Adults without problems getting referral to a specialist in past year | MEPS | |
People not very satisfied with professional staff at provider's office | MEPS | |
People who usually wait > 30 minutes before seeing provider | MEPS | |
Emergent/urgent emergency department visits with wait of > 1 hour | NHAMCS-ED | |
Semi-urgent/non-urgent emergency department visits with wait of > 1 hour | NHAMCS-ED | |
Emergency department visits in which the patient left without being seen | NHAMCS-ED |
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Topic | Measure | National Databasea |
---|---|---|
Patient-Provider Communication | People with provider who generally listens and gives needed information about health/health care | MEPS |
People with provider who usually asks about medications and treatments other doctors may give | MEPS | |
Adults whose providers always listened carefully to them | MEPS | |
Adults whose providers always explained things in a way they could understand | MEPS | |
Adults whose providers always showed respect for what they had to say | MEPS | |
Adults with one or more indicators of poor communication at their last visit | Commonwealth | |
Patient-Provider Relationship | People not satisfied with quality of care received from provider | MEPS |
People not confident in provider's help when they have a medical problem | MEPS | |
Adults whose providers always spent enough time with them | MEPS | |
Adults who rate their health care on a scale from 0-10 (0-6, 7-8, 9-10) | MEPS | |
Adults not treated with a great deal of dignity and respect | Commonwealth | |
Adults not involved as much as wanted in decisionmaking | Commonwealth | |
Adults with not as much time as wanted with doctor | Commonwealth | |
Adults with incident in past 2 years when they did not follow doctor's advice | Commonwealth | |
Adults who report that they or a family member got sick due to doctor or hospital mistake | Commonwealth | |
Cultural Competency | Adults who believe they would have gotten better care if different race/ethnicity | Commonwealth |
Adults who felt treated with disrespect because of race/ethnicity | Commonwealth | |
Adults who do not strongly agree that doctor understands background and values | Commonwealth | |
Health Information | Adults who did not find prescription bottle very easy to understand | Commonwealth |
Adults who did not find information from doctor's office very easy to understand | Commonwealth | |
Adults who do not use Web for health information | Commonwealth | |
Adults who do not use printed material for health information | Commonwealth | |
Adults who do not call their doctor for health information | Commonwealth |
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Topic | Measure | National Databasea |
---|---|---|
Overall Utilization | People with office or outpatient visit | MEPS |
People with prescription medications | MEPS | |
People with dental visit | MEPS | |
People with emergency room visit | MEPS | |
People with inpatient discharge | MEPS | |
People with home health visit | MEPS | |
Care in Doctors' Offices and Hospital Outpatient Departments | Outpatient visits per 100 population | NAMCS/NHAMCS-OPD |
Outpatient visits where patient was seen before in clinic or practice | NAMCS/NHAMCS-OPD | |
Outpatient visits where patient was seen by patient's primary care provider | NAMCS/NHAMCS-OPD | |
Outpatient visits where patient was seen for non-illness care | NAMCS/NHAMCS-OPD | |
Outpatient visits with counseling or education about diet or nutrition | NAMCS/NHAMCS-OPD | |
Outpatient visits with counseling or education about exercise | NAMCS/NHAMCS-OPD | |
Outpatient visits with counseling or education about tobacco use and exposure | NAMCS/NHAMCS-OPD | |
Outpatient visits where physician spent >30 minutes with patient | NAMCS/NHAMCS-OPD | |
Referred Care | Outpatient visits where patient was referred by another physician or by a health plan | NAMCS/NHAMCS-OPD |
Outpatient visits where patient was referred to another physician | NAMCS/NHAMCS-OPD | |
Mental Health Care and Substance Abuse Treatment | Adults who received mental health treatment or counseling in the past year | NHSDA |
Adults who received outpatient mental health treatment or counseling | NHSDA | |
Adults who received prescription medications for mental health treatment | NHSDA | |
Adults who received inpatient mental health treatment or counseling | NHSDA | |
Adults with serious mental illness who received mental health treatment or counseling | NHSDA | |
People 12 and older who received illicit drug or alcohol abuse treatment in the past year | NHSDA | |
People 12 and older who needed treatment at a specialty facility for illicit drug use and who received such treatment in the past year | NHSDA | |
Inpatient admissions to specialty mental health organizations per 100,000 population | CPSS | |
Residential care admissions to specialty mental health organizations per 100,000 population | CPSS | |
<24 hour care admissions to specialty mental health organizations per 100,000 population | CPSS | |
HIV Care | Hospitalizations for HIV per 10,000 population | NHDS |
HIV patients with 4 or more ambulatory visits in the past year | HIV Research Network | |
HIV patients with CD4 <50 with 4 or more ambulatory visits in the past year | HIV Research Network | |
HIV patients with inpatient hospitalization in the past year | HIV Research Network | |
HIV patients with CD4 <50 with inpatient hospitalization in the past year | HIV Research Network | |
Emergency Care | Emergency department visits per 100 population | NHAMCS-ED |
Emergency department visits for injury or poisoning per 10,000 population | NHAMCS-ED | |
Emergency department visits for asthma per 10,000 populationb | NHAMCS-ED | |
Emergency department visits where patient was seen by intern/resident only | NHAMCS-ED | |
Inpatient Care | Total hospitalizations per 100 population | NHDS |
Avoidable admissions for hypertension per 100,000 population 18 and older | HCUP SID | |
Avoidable admissions for angina per 100,000 population 18 and older | HCUP SID | |
Avoidable admissions for COPD per 100,000 population 18 and older | HCUP SID | |
Avoidable admissions for bacterial pneumonia per 100,000 population | HCUP SID | |
Perforated appendices per 1,000 admissions with appendicitis | HCUP SID | |
Admissions for PTCA per 100,000 population 40 and older | HCUP SID | |
Admissions for coronary artery bypass graft surgery per 100,000 population 40 and older | HDUP SID | |
Admissions for hysterectomy per 100,000 female population 18 and older | HCUP SID | |
Admissions for laminectomy or spinal fusion per 100,000 population 18 and older | HCUP SID | |
Cesarean deliveries per 1,000 deliveries | HCUP SID | |
Vaginal births per 1,000 women with previous cesarean deliveries | HCUP SID | |
Chronic Care | Adult home health care discharges per 10,000 population | NHHCS |
Adult nursing home discharges per 10,000 population | NNHS | |
Adult nursing home discharges who received at least one rehabilitative service | NNHS | |
Adult nursing home discharges who received mental health services | NNHS | |
Adult nursing home discharges who were discharged either recovered or stabilized | NNHS | |
Hospice discharges per 100,000 population | NHHCS |
Return to 2003 NHDR Access Measures
a Key to national database acronyms:
Commonwealth = The
Commonwealth Fund 2001 Health Care Quality Survey
CPSS = Client-Patient
Sample Survey (Substance Abuse and Mental Health Services Administration)
HCUP
SID = Healthcare Cost and Utilization Project State Inpatient Databases (Agency
for Healthcare Research and Quality)
MEPS = Medical
Expenditure Panel Survey (Agency for Healthcare Research and Quality)
NAMCS = National
Ambulatory Medical Care Survey (Centers for Disease Control and Prevention,
National Center for Health Statistics)
NHAMCS-ED = National
Hospital Ambulatory Medical Care Survey-Emergency Department (Centers for
Disease Control and Prevention, National Center for Health Statistics)
NHAMCS-OPD = National
Hospital Ambulatory Medical Care Survey-Outpatient Department (Centers for
Disease Control and Prevention, National Center for Health Statistics)
NHDS = National
Hospital Discharge Survey (Centers for Disease Control and Prevention, National
Center for Health Statistics)
NHHCS = National
Home and Hospice Care Survey (Centers for Disease Control and Prevention,
National Center for Health Statistics)
NHIS = National
Health Interview Survey (Centers for Disease Control and Prevention, National
Center for Health Statistics)
NHSDA = National
Household Survey on Drug Abuse (Substance Abuse and Mental Health Services
Administration)
NNHS = National
Nursing Home Survey (Centers for Disease Control and Prevention, National
Center for Health Statistics)
b Consensus process: Healthy People 2010 (HP2010)
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