National Healthcare Disparities Report: List of Measures (continued)

2004 NHDR Final Access to Care Measures

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
   General Medical Care / Ambulatory Care / Mental Health & Substance Abuse Treatment / HIV Care / Avoidable Admissions / Nursing Home and Home Health Care

Getting Into the Health Care System

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 older 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 usually get appointments for routine care as soon as wanted MEPS
Adults who can sometimes or never 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
Adults who can usually get care for illness or injury as soon as wanted MEPS
Adults who can sometimes or never get care for illness or injury as soon as wanted MEPS

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Getting Care Within the System

Topic Measure National Databasea
Difficulty Getting Care 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 > 1 hour NHAMCS-ED
Semi-urgent/non-urgent emergency department visits with wait > 1 hour NHAMCS-ED
Emergency department visits in which the patient left without being seen NHAMCS-ED

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Patient Perceptions of Their Care

Topic Measure National Databasea
Patient-Provider Communication 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 usually listened carefully to them MEPS
Adults whose providers sometimes or never listened carefully to them MEPS
Adults whose providers always explained things in a way they could understand MEPS
Adults whose providers usually explained things in a way they could understand MEPS
Adults whose providers sometimes or never explained things in a way they could understand MEPS
Adults whose providers always showed respect for what they had to say MEPS
Adults whose providers usually showed respect for what they had to say MEPS
Adults whose providers sometimes or never 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
Adults whose providers always spent enough time with them MEPS
Adults whose providers usually spent enough time with them MEPS
Adults whose providers sometimes or never spent enough time with them MEPS
Adults who rate their health care in the past year 0 to 6 on a scale from 0 to 10 MEPS
Adults who rate their health care in the past year 7 to 8 on a scale from 0 to 10 MEPS
Adults who rate their health care in the past year 9 to 10 on a scale from 0 to 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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Health Care Utilization

Topic Measure National Databasea
General Medical Care People with office or outpatient visit in the past year MEPS
People with a prescription medication in the past year MEPS
People with a dental visit in the past year MEPS
People with an emergency room visit in the past year MEPS
People with inpatient discharge MEPS
Outpatient visits per 100 population NAMCS/NHAMCS-OPD
Emergency department visits per 100 population NHAMCS-ED
Total hospitalizations per 100 population NHDS
Ambulatory Care 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
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
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
Avoidable Admissions  Avoidable admissions for bacterial pneumonia per 100,000 population HCUP SID
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 chronic obstructive pulmonary disease (COPD) per 100,000 population 18 and older HCUP SID
Perforated appendices per 1,000 admissions with appendicitis HCUP SID
Nursing Home and Home Health Care Medicare beneficiaries under 65 with Medicare-covered home health care in the past year MCBS
Medicare beneficiaries 65 and older with Medicare-covered home health care in the past year MCBS
Medicare beneficiaries under 65 with nursing home care in the past year MCBS
Medicare beneficiaries 65 and older with nursing home care in the past year MCBS
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

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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)
MCBS = Medicare Current Beneficiary Survey (Centers for Medicare & Medicaid Services)
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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Current as of May 2005

Internet Citation:

National Healthcare Disparities Report: List of Measures. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/qual/nhdrmeasures/listmeasure.htm

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