From the 2004 National Healthcare Quality/Disparities Reports
Fact Sheet
This fact sheet presents findings from the 2004 National Healthcare Quality Report (NHQR) and National Healthcare Disparities Report (NHDR) on health care quality, access, and utilization for children and adolescents.
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Contents
Introduction
Importance of Child and Adolescent Health Care
Selected Key Findings
For More Information
Introduction
Information on health care quality,
access, and utilization for the Nation's
children and adolescents is available
from the 2004 National Healthcare
Quality Report (NHQR) and National
Healthcare Disparities Report
(NHDR). These reports are produced
annually, beginning in 2003, by the
Agency for Healthcare Research and
Quality (AHRQ) on behalf of the U.S.
Department of Health and Human
Services (HHS).
This fact sheet uses findings from both
reports to:
- Briefly note the importance of focusing on child and adolescent health and health care.
- Highlight key findings from both reports in selected areas of quality of and access to care, including disparities in quality and access.
- List the NHQR and NHDR appendix tables (list)
that provide additional data on the state of quality and access for children
and
adolescents, including disparities by racial and ethnic minority group and
socioeconomic status. These detailed tables, along with the full reports, are
available online at: http://www.ahrq.gov/qual/measurix.htm.
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Importance of Child and Adolescent Health Care
Children and adolescents ages 0-17
constitute 73 million individuals, or
one-fourth of the Nation's population.
Health care providers and government
agencies and other entities recommend
that all children have access to high
quality services for health promotion,
disease prevention, and acute and
chronic care treatment and
management.
Although children and
adolescents are generally healthier than
adults, from 13 to 23 percent of this
population experience special health
care needs or chronic illnesses and
disabilities. Among the most prevalent
chronic conditions of childhood and
adolescence in 2002 were:
- Asthma (affecting 12 percent of children ages 0-17).
- Learning disabilities (8 percent of children 3 to 17).
- Attention-deficit hyperactivity disorder (7 percent of children 3 to 17).
Infants (children
under 12 months) have a higher death
rate than any other age group under age
55.
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Selected Key Findings
Three aspects of quality of care for
children and adolescents are presented
below:
One
aspect of access to care is also discussed:
Overweight Prevention
Overweight in
children is defined by the Centers for
Disease Control and Prevention as body
mass index (BMI) for age >95th
percentile.1 Although not a disease per
se, overweight, if unchecked, can lead
to diseases such as obesity, diabetes, and
heart disease.
Overweight among
children has increased over time. In
2000, 15.3 percent of children ages 6-11 were overweight, compared to 11
percent in 1988-94.
- In 2001, 70.7 percent of children ages 0-17 had both their height and weight measured within the last year by doctors or other health care professionals, according to parents' reports; 84.5 percent of children had height and weight measured within the last 2 years (Figure 1).
- In 2001, 36 percent of children ages 2-17 or their parents were counseled on healthy eating within the year before the survey; 43.7 percent had been counseled on healthy eating within the last 2 years.
- In 2001, 22.8 percent of children ages 2-17 or their parents got counseling about the value of physical activity from doctors or other health professionals within the last year; 26.3 percent got counseling about physical activity within the last 2 years.
1. BMI is used differently for children and teens (i.e., BMI-for-age) than for adults. See http://www.cdc.gov/nccdphp/dnpa/healthyweight/assessing/bmi/childrens_BMI/about_childrens_BMI.htm for more information.
Antibiotic Prescribing for the Common Cold
Antibiotics should not
be prescribed for the common cold,
which is a viral illness against which
antibiotics are ineffective. Antibiotic
overuse can lead to antibiotic resistance,
an important public health problem.
- Children ages 0-17 were prescribed an antibiotic at a visit for a common cold at a rate of 333.79 per 10,000 visits in 2000-01, about twice the rate of such prescriptions for the U.S. population overall (184.28 per 10,000 visits; Figure 2).
- Antibiotic prescribing for the common cold declined for both groups between the 1997-98 and 2000-01 time periods.
Hospital Admissions for Pediatric
Asthma
Asthma can be effectively
controlled over the long term with
recommended medication. Preventing
hospital admissions for asthma is one
measure of successful management of
asthma.
- Child asthma admission rates vary from 98 admissions per 100,000 population for the best performing quartile of States to 261.5 admissions per 100,000 population for the lowest performing quartile of States—a difference of 167 percent (Figure 3).
- While prevalence rates vary by age, admission rates nationally for children are more than twice those for adults—26.2 admissions for children per 100,000 population in 2001 vs. 12.5 admissions for adults per 100,000 population (National Hospital Discharge Survey, 2001; 2004 NHQR Tables Appendix, Tables 1.93a, 1.94a).
- Black children are roughly three times more likely to be hospitalized for asthma than are white children—55.9 black children versus 16.2 white children per 10,000 children ages 0-17 in 2001 (Figure 4).
Insurance Coverage
Insurance
coverage is a key determinant of access
to care.
- In all 3 years from 1999 to 2001, Hispanic children were less likely than non-Hispanic white children to have heath insurance (Figure 5).
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For More Information
For specific references to all detailed
tables on child and adolescent health in
the 2004 National Healthcare Quality
Report and National Healthcare
Disparities Report, go to http://www.ahrq.gov/qual/nhqrdrchapp.htm.
Futher information on AHRQ's
programs and other activities in child
and adolescent health is also available
on the AHRQ Web site at http://www.ahrq.gov/child/ and from:
Denise Dougherty, Ph.D.
Senior Advisor, Child Health and Quality Improvement
Agency for Healthcare Research and Quality
540 Gaither Road
Rockville, MD 20850
Phone: (301) 427-1868
Fax: (301) 427-1562
E-mail: Denise.Dougherty@ahrq.hhs.gov
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AHRQ Publication No. 05-P011
Current as of March 2005
Internet Citation:
Selected Findings on Child and Adolescent Health Care from the 2004 National Healthcare Quality/Disparities Reports. Fact Sheet. AHRQ Publication No. 05-P011, March 2005. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/qual/nhqrchild/nhqrchild.htm