Priority Populations: Racial and Ethnic Minorities

Measure Title

Hospitalizations for uncontrolled diabetes in Indian Health Service areas.

Measure Source

Agency for Healthcare Research and Quality (AHRQ), Prevention Quality Indicators (PQI).

Table

260 Hospitalizations for uncontrolled diabetes per 100,000 American Indian/Alaska Native population age 18 and over in Indian Health Service and Tribal hospitals, 2004

Data Source

Indian Health Service (IHS), National Patient Information Reporting System (NPIRS).

Denominator

Population in Indian Health Service areas.

Numerator

Subset of population hospitalized with principal diagnosis of uncontrolled diabetes, without mention of a short-term (ketoacidosis, hyperosmolarity, coma) or long-term (renal, eye, neurological, circulatory, other unspecified) complication.

Comments

This measure is adapted from the AHRQ Prevention Quality Indicators. The ICD-9-CM codes used to identify discharges for uncontrolled diabetes are the same as those used for the corresponding AHRQ measure, but the format of NPIRS did not allow for exclusion of transfers.

The numerator includes hospitalizations in IHS hospitals and contract hospitals with admissions during the study period. Because of concerns about the quality of the data, hospitalizations from some regions are deleted; the denominator is correspondingly reduced.

The total estimates are age adjusted using the total U.S. population for 2000 as the standard population.

Measure Title

Admissions for perforated appendix to Indian Health Service hospitals per 1,000 population in Indian Health Service areas.

Measure Source

Agency for Healthcare Research and Quality (AHRQ), Prevention Quality Indicators (PQI).

Table

261 Hospitalizations for perforated appendix per 1,000 hospitalizations for American Indians/Alaska Natives with appendicitis in Indian Health Service and Tribal hospitals, 2004

Data Source

Indian Health Service (IHS), National Patient Information Reporting System (NPIRS).

Denominator

Population in Indian Health Service areas.

Numerator

Subset of the denominator with principal or secondary diagnosis code for perforation or abscess of appendix.

Comments

This measure is adapted from the AHRQ Prevention Quality Indicators, where it is referred to as indicator 2. The ICD-9-CM codes used to identify discharges for uncontrolled diabetes are the same as AHRQ Prevention Quality Indicator 2, but the format of NPIRS did not allow for exclusion of transfers.

The numerator includes hospitalizations in IHS Service hospitals and contract hospitals with admissions during the target period. Because of concerns about the quality of the data, hospitalizations from the California and Portland regions are deleted; the denominator is correspondingly reduced.

The total estimates are age adjusted using the total U.S. population for 2000 as the standard population.

Measure Title

Hospitalizations for urinary tract infection per 1,000 admissions in Indian Health Service and Tribal hospitals.

Measure Source

Agency for Healthcare Research and Quality (AHRQ), Prevention Quality Indicators (PQI).

Table

262 Hospitalizations for urinary tract infection per 100,000 American Indians/Alaska Native population age 18 and over in Indian Health Service and Tribal hospitals, 2004

Data Source

Indian Health Service (IHS), National Patient Information Reporting System (NPIRS).

Denominator

Admissions in Indian Health Service facilities and Tribal hospitals.

Numerator

Subset of denominator with documented urinary tract infection.

Measure Title

Hospital admissions for asthma per 100,000 population under 18.

Measure Source

Healthy People 2010.

Table

117 Pediatric asthma admissions (excluding patients with cystic fibrosis or anomalies of the respiratory system and transfers from other institutions) per 100,000 population, ages 2-17, United States, 2004, by

• Race/ethnicity.

Data Source

Agency for Healthcare Research and Quality (AHRQ), Center for Delivery, Organization, and Markets (CDOM), Healthcare Cost and Utilization Project (HCUP).

Denominator

U.S. civilian population: children under age 18.

Numerator

Number of discharges with principal diagnosis of asthma (ICD-9-CM code 493) among children under age 18.

Comments

Rates are adjusted by age and gender using the total U.S. population for 2000 as the standard population. When reporting is by age, the adjustment is by gender only; when reporting is by gender, the adjustment is by age only.

The disparities analysis file, created specifically for this report to provide national estimates on disparities, consists of weighted records from a sample of hospitals from the following 23 States that participate in HCUP and have high-quality race/ethnicity data: AZ, AR, CA, CO, CT, FL, GA, HI, KS, MD, MA, MI, MO, NH, NJ, NY, RI, SC, TN, TX, VA, VT, and WI.

Tables were created using version 2.1, revision 3, of the AHRQ Prevention Quality Indicators software. This measure is referred to as indicator 4 in the AHRQ Prevention Quality Indicators software documentation. More information about the AHRQ Quality Indicators is available at http://www.qualityindicators.ahrq.gov.

This measure and its tables are also presented in other relevant sections of the report.

This measure is referred to as measures 24-2 and 1-9a in Healthy People 2010 documentation.

Measure Title

Women age 40 and over who report they had a mammogram within the past 2 years.

Measure Source

Healthy People 2010.

National Tables

1a Women age 40 and over who reported they had a mammogram within the past 2 years, United States, 2005, by

• Race.
• Ethnicity.
• Family income.

National Data Source

Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS), National Health Interview Survey (NHIS).

National Denominator

U.S. female resident population age 40 and over.

National Numerator

Number of women age 40 and over who report receiving a mammogram within the past 2 years.

State Tables

1b Women age 40 and over who reported they had a mammogram within the past 2 years, California, 2005, by

• Race.
• Ethnicity.
• Family income.
• Asian ethnicity.

State Data Source

University of California, Los Angeles (UCLA), California Health Interview Survey (CHIS).

State Denominator

California civilian women age 40 and over, excluding people residing in group quarters.

State Numerator

Number of women age 40 and over who report receiving a mammogram within the past 2 years.

Comments

Data reported in national table are age adjusted to the 2000 standard population. Age-adjusted rates are weighted sums of age-specific rates. For a discussion of age adjustment, see Part A, Section 5, of Tracking Healthy People 2010.

This measure and its tables are also presented in other relevant sections of the report.

This measure is referred to as measure 3-13 in Healthy People 2010 documentation.

Measure Title

Women age 40 and over who report they had a mammogram within the past 2 years.

Measure Source

University of California, Los Angeles (UCLA), Center for Health Policy Research (CHPR), California Health Interview Survey (CHIS).

Tables

1b Women age 40 and over who reported they had a mammogram within the past 2 years, California, 2005, by

• Race.
• Ethnicity.
• Family income.
• Asian ethnicity.

Data Source

University of California, Los Angeles (UCLA), California Health Interview Survey (CHIS).

Denominator

California civilian women age 40 and over, excluding people residing in group quarters.

Numerator

Number of women age 40 and over who report receiving a mammogram within the past 2 years.

Comments

Data reported in national table are age adjusted to the 2000 standard population. Age-adjusted rates are weighted sums of age-specific rates. For a discussion of age adjustment, see Part A, Section 5, of Tracking Healthy People 2010.

This measure and its tables are also presented in other relevant sections of the report.

This measure is referred to as measure 3-13 in Healthy People 2010 documentation.

Measure Title

Composite measure: Adults age 40 and over with diabetes who had all three recommended services for diabetes in the past year (at least one hemoglobin A1c measurement, a retinal eye examination, and a foot examination).

Measure Source

University of California, Los Angeles (UCLA), Center for Health Policy Research (CHPR), C (CHIS).

Tables

19b Diabetes patients age 40 and over who ever had hemoglobin A1c measurement, retinal eye examination, and foot examination within the past year, California, 2005, by

• Race.
• Ethnicity.
• Family income.
• Asian ethnicity.

Data Source

University of California, Los Angeles (UCLA), California Health Interview Survey (CHIS).

Denominator

California civilian population age 40 and older with diabetes who answered the Diabetes Care Survey (DCS) question and had valid, non-missing responses to all three questions, excluding people residing in group quarters.

Numerator

Adults age 40 and older with diabetes whose answers indicated they had at least one hemoglobin A1c test, a retinal eye examination, and a foot examination in the study period.

Measure Title

People under age 65 who were uninsured all year.

Measure Source

University of California, Los Angeles (UCLA), Center for Health Policy Research (CHPR), California Health Interview Survey (CHIS).

Tables

213b People under age 65 who were uninsured all year during the past year, California, 2005, by

• Race.
• Ethnicity.
• Family income.
• Asian ethnicity.

Data Source

UCLA, CHIS.

Denominator

California civilian population under age 65, excluding people residing in group quarters.

Numerator

Population under age 65 who reported no private or public health insurance coverage at any time during the year.

Comments

This measure and its tables are also presented in other relevant sections of the report.

Measure Title

Noninstitutionalized adults age 65 and over who received influenza vaccine in the past year.

Measure Source

University of California, Los Angeles (UCLA), Center for Health Policy Research (CHPR), California Health Interview Survey (CHIS).

Tables

105b Adults age 65 and over who received influenza vaccine within the past year, California, 2005, by

• Race.
• Ethnicity.
• Family income.
• Asian ethnicity.

Data Source

University of California, Los Angeles (UCLA), California Health Interview Survey (CHIS).

Denominator

California civilian population age 65 and over, excluding people residing in group quarters.

Numerator

Number of adults age 65 and over who report receiving an influenza vaccination in the past 12 months.

Comments

This measure is one of the components of the Immunization Leading Health Indicators, which further defines the measure as pertaining to high-risk adults. See Appendix H of Tracking Healthy People 2010 for a complete listing of Leading Health Indicators.

Data reported in national tables are age adjusted to the 2000 standard population. Age-adjusted percents are weighted sums of age-specific percents. For a discussion of age adjustment, see Part A, Section 5, of Tracking Healthy People 2010.

This measure and its tables are also presented in other relevant sections of the report.

This measure is referred to as measure 14-29a in Healthy People 2010 documentation.

Measure Title

People currently with asthma who ever had emergency room/urgent care clinic visits for asthma within the past year.

Measure Source

University of California, Los Angeles (UCLA), Center for Health Policy Research (CHPR), California Health Interview Survey (CHIS).

Tables

119 People currently with asthma who ever had emergency room/urgent care clinic visits for asthma within the past year, California, 2005, by

• Race.
• Ethnicity.
• Family income.
• Asian ethnicity.

Data Source

UCLA, CHIS.

Denominator

California civilian population who indicated they had asthma, excluding people residing in group quarters.

Numerator

Subset of denominator who answered "yes" to the question: "During the past 12 months, have you had to visit a hospital emergency room or urgent care clinic because of your asthma?"

Comments

This measure and its tables are also presented in other relevant sections of the report.

Measure Title

People with an emergency room visit in the past year.

Measure Source

University of California, Los Angeles (UCLA), Center for Health Policy Research (CHPR), California Health Interview Survey (CHIS).

Tables

233b People with an emergency room visit within the past year, California, 2005, by

• Race.
• Ethnicity.
• Family income.
• Asian ethnicity.

Data Source

UCLA, CHIS.

Denominator

California civilian population, excluding people residing in group quarters.

Numerator

Population who reported at least one emergency room visit.

Comments

This measure and its tables are also presented in other relevant sections of the report.

Measure Title

Women age 40 and over who report they had a mammogram within the past 2 years.

Measure Source

Healthy People 2010.

National Tables

1a Women age 40 and over who reported they had a mammogram within the past 2 years, United States, 2005, by

• Race.
• Ethnicity.
• Family income.

National Data Source

Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS), National Health Interview Survey (NHIS).

National Denominator

U.S female resident population age 40 and over.

National Numerator

Number of women age 40 and over who report receiving a mammogram within the past 2 years.

State Tables

1b Women age 40 and over who reported they had a mammogram within the past 2 years, California, 2005, by

• Race.
• Ethnicity.
• Family income.
• Asian ethnicity.

State Data Source

University of California, Los Angeles (UCLA), California Health Interview Survey (CHIS).

State Denominator

California female civilian population age 40 and over, excluding people residing in group quarters.

State Numerator

Number of women age 40 and over who report receiving a mammogram within the past 2 years.

Comments

Data reported in national table are age adjusted to the 2000 standard population. Age-adjusted rates are weighted sums of age-specific rates. For a discussion of age adjustment, see Part A, Section 5, of Tracking Healthy People 2010.

This measure and its tables are also presented in other relevant sections of the report.

This measure is referred to as measure 3-13 in Healthy People 2010 documentation.

Measure Title

Composite measure: Adults age 40 and over with diabetes who had all three recommended services for diabetes in the past year (at least one hemoglobin A1c measurement, a retinal eye examination, and a foot examination).

Measure Source

Healthy People 2010.

National Alliance for Diabetes Quality Improvement, National Quality Forum, 2002.

National Tables

19a Adults age 40 and over with diabetes who had a hemoglobin A1c test, a retinal eye examination, and a foot examination in the past year, United States, 2004, by

• Race.
• Ethnicity.
• Family income.
• Education.

National Data Source

Agency for Healthcare Research and Quality (AHRQ), Center for Financing, Access, and Cost Trends (CFACT), Medical Expenditure Panel Survey (MEPS).

National Denominator

U.S. civilian noninstitutionalized adults age 40 and older with diabetes who answered the Diabetes Care Survey (DCS) question and had valid, non-missing responses to all three questions.

National Numerator

U.S. civilian noninstitutionalized adults age 40 and older with diabetes whose answers indicated they had at least one hemoglobin A1c test, a retinal eye examination, and a foot examination in the study period.

State Tables

19b Diabetes patients age 40 and over who ever had hemoglobin A1c measurement, retinal eye examination, and foot examination within the past year, California, 2005, by

• Race.
• Ethnicity.
• Family income.
• Asian ethnicity.

State Data Source

University of California, Los Angeles (UCLA), California Health Interview Survey (CHIS).

State Denominator

California civilian population age 40 and older with diabetes who answered the Diabetes Care Survey (DCS) question and had valid, non-missing responses to all three questions, excluding people residing in group quarters..

State Numerator

Population age 40 and older with diabetes whose answers indicated they had at least 1 hemoglobin A1c test, a retinal eye examination, and a foot examination in the study period.

Comments

The criteria for selecting the diabetes population from the MEPS survey and the methodology for calculating the diabetes composite measure have changed; reported rates may not be comparable with those found in prior years' editions of the National Healthcare Disparities Report.

Nonresponses and "Don't know" responses to the DCS question were excluded from the analysis.

National estimates are age adjusted to the 2000 standard population with two age groups: 40-59, 60 and over.

See entries for each of the three components of the composite measure for further details about the individual survey questions.

This measure and its tables are also presented in other relevant sections of the report.

The measures that comprise this composite measure are referred to as measures 5-12, 5-13, and 5-14 in Healthy People 2010 documentation.

Measure Title

People under age 65 who were uninsured all year.

Measure Source

Agency for Healthcare Research and Quality (AHRQ), Center for Financing, Access, and Cost Trends (CFACT), Medical Expenditure Panel Survey (MEPS).

University of California, Los Angeles (UCLA), Center for Health Policy Research (CHPR), California Health Interview Survey (CHIS).

National Tables

213a People under age 65 uninsured all year, United States, 2004, by

• Race.
• Ethnicity.
• Family income.
• Education.

National Data Source

AHRQ, CFACT, MEPS.

National Denominator

U.S. civilian noninstitutionalized population under age 65.

National Numerator

U.S. civilian noninstitutionalized population under age 65 who reported no private or public health insurance coverage at any time during the year.

State Tables

213b People under age 65 who were uninsured all year during the past year, California, 2005, by

• Race.
• Ethnicity.
• Family income.
• Asian ethnicity.

State Data Source

UCLA, CHIS.

State Denominator

California civilian population under age 65, excluding people residing in group quarters.

State Numerator

Population under age 65 who reported no private or public health insurance coverage at any time during the year.

Comments

This measure and its tables are also presented in other relevant sections of the report.

Measure Title

People currently with asthma who ever had emergency room/urgent care clinic visits for asthma within the past year.

Measure Source

University of California, Los Angeles (UCLA), Center for Health Policy Research (CHPR), California Health Interview Survey (CHIS).

Tables

119 People currently with asthma who ever had emergency room/urgent care clinic visits for asthma within the past year, California, 2005, by

• Race.
• Ethnicity.
• Family income.
• Asian ethnicity.

Data Source

UCLA, CHIS.

Denominator

California civilian population who indicated they had asthma, excluding people residing in group quarters.

Numerator

Subset of denominator who answered "yes" to the question: "During the past 12 months, have you had to visit a hospital emergency room or urgent care clinic because of your asthma?"

Comments

This measure and its tables are also presented in other relevant sections of the report.

Measure Title

Women age 40 and over who report they had a mammogram within the past 2 years.

Measure Source

Healthy People 2010.

National Tables

1a Women age 40 and over who reported they had a mammogram within the past 2 years, United States, 2005, by

• Race.
• Ethnicity.
• Family income.

National Data Source

Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS), National Health Interview Survey (NHIS).

National Denominator

U.S. female resident population age 40 and over.

National Numerator

Number of women age 40 and over who report receiving a mammogram within the past 2 years.

State Tables

1b Women age 40 and over who reported they had a mammogram within the past 2 years, California, 2005, by

• Race.
• Ethnicity.
• Family income.
• Asian ethnicity.

State Data Source

University of California, Los Angeles (UCLA), California Health Interview Survey (CHIS).

State Denominator

California female civilian population age 40 and over, excluding people residing in group quarters.

State Numerator

Number of women age 40 and over who report receiving a mammogram within the past 2 years.

Comments

Data reported in national table are age adjusted to the 2000 standard population. Age-adjusted rates are weighted sums of age-specific rates. For a discussion of age adjustment, see Part A, Section 5, of Tracking Healthy People 2010.

This measure and its tables are also presented in other relevant sections of the report.

This measure is referred to as measure 3-13 in Healthy People 2010 documentation.

Measure Title

Composite measure: Adults age 40 and over with diabetes who had all three recommended services for diabetes in the past year (at least one hemoglobin A1c measurement, a retinal eye examination, and a foot examination).

Measure Source

Healthy People 2010.

National Alliance for Diabetes Quality Improvement, National Quality Forum, 2002.

National Tables

19a Adults age 40 and over with diabetes who had a hemoglobin A1c test, a retinal eye examination, and a foot examination in the past year, United States, 2004, by

• Race.
• Ethnicity.
• Family income.
• Education.

National Data Source

Agency for Healthcare Research and Quality (AHRQ), Center for Financing, Access, and Cost Trends (CFACT), Medical Expenditure Panel Survey (MEPS).

National Denominator

U.S. civilian noninstitutionalized adults age 40 and older with diabetes who answered the Diabetes Care Survey (DCS) question and had valid, non-missing responses to all three questions.

National Numerator

U.S. civilian noninstitutionalized adults age 40 and older with diabetes whose answers indicated they had at least one hemoglobin A1c test, a retinal eye examination, and a foot examination in the study period.

State Tables

19b Diabetes patients age 40 and over who ever had hemoglobin A1c measurement, retinal eye examination and foot examination within the past year, California, 2005, by

• Race.
• Ethnicity.
• Family income.
• Asian ethnicity.

State Data Source

University of California, Los Angeles (UCLA), California Health Interview Survey (CHIS).

State Denominator

California civilian population age 40 and older with diabetes who answered the Diabetes Care Survey (DCS) question and had valid, non-missing responses to all three questions, excluding people residing in group quarters.

State Numerator

Adults age 40 and older with diabetes whose answers indicated they had at least one hemoglobin A1c test, a retinal eye examination, and a foot examination in the study period.

Comments

The criteria for selecting the diabetes population from the MEPS survey and the methodology for calculating the diabetes composite measure have changed; reported rates may not be comparable with those found in prior years' editions of the National Healthcare Disparities Report.

Nonresponses and "Don't know" responses to the DCS question were excluded from the analysis.

National estimates are age adjusted to the 2000 standard population with two age groups: 40-59, 60 and over.

See entries for each of the three components of the composite measure for further details about the individual survey questions.

This measure and its tables are also presented in other relevant sections of the report.

The measures that comprise this composite measure are referred to as measures 5-12, 5-13, and 5-14 in Healthy People 2010 documentation.

Measure Title

Tuberculosis patients who complete a curative course of treatment within 12 months of initiation of treatment.

Measure Source

American Thoracic Society.

Centers for Disease Control and Prevention (CDC), Division of Tuberculosis Elimination.

Tables

120 Tuberculosis patients who completed a curative course of treatment within 12 months of initiation of treatment, United States, 2003, by

• Race.
• Ethnicity.
• Race (foreign born only).
• Ethnicity (foreign born only).

Data Source

CDC, National Tuberculosis Surveillance System (NTBSS).

Denominator

U.S. resident population with verified tuberculosis.

Numerator

Tuberculosis cases completing therapy within 1 year.

Comments

See American Thoracic Society/Centers for Disease Control and Prevention/Infectious Diseases Society of America: Treatment of Tuberculosis, Am J Respir Crit Care Med, 2003, 167:603-662, for further information regarding current tuberculosis treatment guidelines.

For a discussion of completion of TB therapy, see Appendix A of CDC publication Reported Tuberculosis in the United States, 2003, available at http://www.cdc.gov/tb/surv/.

This measure and its tables are also presented in other relevant sections of the report.

Measure Title

Composite measure: Adults who sometimes or never received patient centered care (whose health providers sometimes or never listened carefully, explained things clearly, respected what they had to say, and spent enough time with them).

Measure Source

Agency for Healthcare Research and Quality (AHRQ), Center for Financing, Access, and Cost Trends (CFACT), Medical Expenditure Panel Survey (MEPS).

Tables

189a Adults whose health providers always listened carefully, explained things clearly, respected what they had to say, and spent enough time with them, United States, 2004, by

• Race.
• Ethnicity.
• Family income.
• Education.

189b Adults whose health providers usually listened carefully, explained things clearly, respected what they had to say, and spent enough time with them, United States, 2004, by

• Race.
• Ethnicity.
• Family income.
• Education.

189c Adults whose health providers sometimes or never listened carefully, explained things clearly, respected what they had to say, and spent enough time with them, United States, 2004, by

• Race.
• Ethnicity.
• Family income.
• Education.

Data Source

AHRQ, CFACT, MEPS.

Denominator

U.S. civilian noninstitutionalized adults age 18 and older who had at least one visit to a doctor's office or clinic in the previous 12 months (not including visits to an emergency room).

Numerator

U.S. civilian noninstitutionalized adults age 18 and older who had at least one visit to a doctor's office or clinic in the previous 12 months (not including visits to an emergency room) who subsequently reported their provider's level of communication on some or all of the four components of the composite measure as: always, usually, sometimes, or never, depending on the table.

Comments

This measure and its tables are also presented in other relevant sections of the report.

Percent estimates are weighted; percent weights are adjusted for nonresponse based on how many of the questions had a valid response.

Tables report data from the MEPS Self-Administered Questionnaire (SAQ). See the MEPS entry in the Data Sources Appendix for more information on the SAQ.

Measure Title

People under age 65 who were uninsured all year.

Measure Source

Agency for Healthcare Research and Quality (AHRQ), Center for Financing, Access, and Cost Trends (CFACT), Medical Expenditure Panel Survey (MEPS).

University of California, Los Angeles (UCLA), Center for Health Policy Research (CHPR), California Health Interview Survey (CHIS).

National Tables

213a People under age 65 uninsured all year, United States, 2004, by

• Race.
• Ethnicity.
• Family income.
• Education.

National Data Source

AHRQ, CFACT, MEPS.

National Denominator

U.S. civilian noninstitutionalized population under age 65.

National Numerator

U.S. civilian noninstitutionalized population under age 65 who reported no private or public health insurance coverage at any time during the year.

State Tables

213b People under age 65 who were uninsured all year during the past year, California, 2005, by

• Race.
• Ethnicity.
• Family income.
• Asian ethnicity.

State Data Source

UCLA, CHIS.

State Denominator

California civilian population under age 65, excluding people residing in group quarters.

State Numerator

Population under age 65 who reported no private or public health insurance coverage at any time during the year.

Comments

This measure and its tables are also presented in other relevant sections of the report.

Measure Title

Adults with limited English proficiency with and without a usual source of care who offers language assistance.

Measure Source

Agency for Healthcare Research and Quality (AHRQ), Center for Financing, Access, and Cost Trends (CFACT), Medical Expenditure Panel Survey (MEPS).

Table

263 Adults age 18 and over with limited English proficiency with and without a usual source of care who offers language assistance, United States, 2004, by

• Ethnicity.

Data Source

AHRQ, CFACT, MEPS.

Denominator

U.S. civilian noninstitutionalized population with limited English proficiency.

Numerator

Subset of denominator with and without a usual source of care who offers language assistance.