The 2004 National Healthcare Quality Report (NHQR) examines 179 measures within four quality components of the Nation's health care system: effectiveness, patient safety, timeliness, and patient centeredness; within the effectiveness component, nine condition areas or care settings are tracked—cancer, diabetes, end stage renal disease, heart disease, HIV/AIDS, maternal and child health, mental health, respiratory diseases, and nursing home/home health care. Where data are available, the NHQR also presents State-level findings.
The 2004 National Healthcare Disparities Report (NHDR) uses the same quality components as its companion report to examine disparities in health care quality overall. In addition, the NHDR examines disparities in quality and access to care for AHRQ's congressionally designated priority populations, including ethnic and racial minorities, low income groups, rural residents, elderly, women, children, and people with special health care needs.
The table below lists the measures in the NHQR and NHDR with data for children and adolescents under age 18. Table numbers refer to the detailed appendix tables in each report with data on that population. These appendix tables are online at: www.qualitytools.ahrq.gov/
| Topic | Measure | NHQR National Table Number | NHQR State Table Number | NHDR National Table Numberii |
|---|---|---|---|---|
Quality of Careiii: Effectivenessiv Cancer |
Cancer deaths per 100,000 persons per year for all cancers (ages 0-17)v | 1.8a | 1.8b | 5a,b |
Quality of Careiii: Effectivenessiv End Stage Renal Disease |
Percent of dialysis patients registered on waiting list for transplantation (ages 0-17) | 1.27a | x | 22a,b |
| Percent of patients with treated chronic kidney failure who receive a transplant within 3 years of renal failure (ages 0-17) | 1.28a | x | 23a,b | |
Quality of Careiii: Effectivenessiv Heart Disease |
Deaths per 1,000 pediatric heart surgery admissions (ages 0-4, 5-9, 10-14, 15-17) | 1.48 | x | 33a |
Quality of Careiii: Effectivenessiv HIV and AIDS |
New AIDS cases per 100,000 population (ages 13-17) | 1.54 | x | 34a |
| HIV infection deaths per 100,000 population (ages 0-17) | 1.55a | x | 35a,b | |
Quality of Careiii: Effectivenessiv Maternal and Child Health: Maternity Care |
Pregnant women receiving prenatal care in first trimester (ages < 15, 15-19) | x | x | 36a,b |
| Maternal deaths per 100,000 live births (age < 20) | 1.59a | 1.59b | 43a,b | |
| Infant mortality per 1,000 live births, all (maternal ages < 15, 15-19) | 1.58a | x | 39a,b | |
| Infant mortality per 1,000 live births, birthweight < 1,500 grams (maternal ages < 15, 15-19) | x | x | 40a,b | |
| Infant mortality per 1,000 live births, birthweight 1500-2499 grams (maternal ages < 15, 15-19) | x | x | 41a,b | |
| Infant mortality per 1,000 live births, birthweight > 2,499 grams (maternal ages < 15, 15-19) | x | x | 42a,b | |
| Percent of live-born infants with low and very low birthweight (less than 2,500 grams, less than 1,500 grams) (maternal ages < 15, 15-19) | 1.57a (<2,500 g) 1.57b (<1,500 g) |
1.57c (<2,500 g) 1.57d (<1,500 g) |
37a,b 38a,b |
|
Quality of Careiii: Effectivenessiv Maternal and Child Health: Immunizations, children ages 19-35 months |
Percent of children 19-35 months who received all recommended vaccines | 1.60a | 1.60b | 44a,b,c |
| Percent of children 19-35 months who received 4 doses of diphtheria-pertussis-tetanus vaccine | x | x | 45a,b,c | |
| Percent of children 19-35 months who received 3 doses of polio vaccine | x | x | 46a,b,c | |
| Percent of children 19-35 months who received 1 dose of measles-mumps-rubella vaccine | x | x | 47a,b,c | |
| Percent of children 19-35 months who received 3 doses of Haemophilus influenzae type B vaccine | x | x | 48a,b,c | |
| Percent of children 19-35 months who received 3 doses of hepatitis B vaccine | x | x | 49a,b,c | |
| Percent of children 19-35 months who received 1 dose of varicella vaccine | x | x | 50a,b,c | |
Quality of Careiii: Effectivenessiv Maternal and Child Health: Immunizations, adolescents ages 13-15 |
Percent of adolescents (ages 13-15) reported to have received 3 or more doses of hepatitis B vaccine | 1.61 | x | 51a,b,c |
| Percent of adolescents (ages 13-15) reported to have received 2 or more doses of measles-mumps-rubella vaccine | 1.62 | x | 52a,b,c | |
| Percent of adolescents (ages 13-15) reported to have received 1 or more doses of tetanus-diphtheria booster | 1.63 | x | 53a,b,c | |
| Percent of adolescents (ages 13-15) reported to have received 1 or more doses of varicella vaccine | 1.64 | x | 54a,b,c | |
Quality of Careiii: Effectivenessiv Maternal and Child Health: Overweight prevention |
Percent of children under age 18 who had their height and weight measured by a doctor or other health provider | 1.67 | x | 56a,b,c |
| Percent of children ages 2-17 for whom a doctor or other health care provider gave advice about amount and kind of physical activity | 1.68 | x | 57a,b,c | |
| Percent of children ages 2-17 for whom a doctor or other health care provider gave advice about eating healthy | 1.69 | x | 58a,b,c | |
Quality of Careiii: Effectivenessiv Maternal and Child Health: Vision health |
Percent of children ages 3-6 whose vision was checked by a doctor or other health provider | 1.70 | X | 59a,b,c |
Quality of Careiii: Effectivenessiv Maternal and Child Health: Passive smoking |
Percent of children under age 18 for whom a doctor or other health provider gave advice about how smoking in the house can be harmful | 1.71 | x | 60a,b,c |
Quality of Careiii: Effectivenessiv Maternal and Child Health: Injury prevention |
Percent of children under age 18 for whom a doctor or other health provider gave advice about using car safety restraints | 1.72 | x | (see 61-64 below) |
| Children 0-40 lbs with advice to parent or guardian about using child car safety seats (ages 0-5, 6-17) | x | x | 61a,b,c | |
| Children 40-80 lbs with advice to parent or guardian about using booster seats (ages 0-5, 6-17) | x | x | 62a,b,c | |
| Children over 80 lbs with advice to parent or guardian about using lap and shoulder belts (ages 0-5, 6-17) | x | x | 63a,b,c | |
| Percent of children ages 2-17 for whom a doctor or other health provider gave advice about using a helmet when riding a bicycle or motorcycle | 1.73 | x | 64a,b,c | |
Quality of Careiii: Effectivenessiv Maternal and Child Health: Dental health |
Percent of children ages 2-17 who report dental visit in last year | 1.65 | x | 65a,b,c |
Quality of Careiii: Effectivenessiv Maternal and Child Health: Management of gastroenteritisvi |
Hospital admissions for pediatric gastroenteritis per 100,000 population less than 18 years of age | 1.66a | 1.66b | 55a |
Quality of Careiii: Effectivenessiv Mental Health |
Deaths due to suicide per 100,000 population (ages 0-17) | 1.77a | 1.77b | 66a,b |
Quality of Careiii: Effectivenessiv Respiratory Diseases |
Antibiotic prescribed at visit with diagnosis of common cold by selected characteristics, United States, per 10,000 visits (ages 0-17) | 1.91 | x | 75a |
| Hospital admissions for pediatric asthma (under age 18) | 1.93a | 1.93b | 76a | |
| Hospital admissions for bacterial pneumonia per 100,000 population In Indian Health Service hospitals (ages 0-17) | x | x | 220a | |
| Tuberculosis patients who compete a curative course of treatment within 12 months of initiation of treatment (ages 0-17) | x | x | 78a,b,c,d | |
Quality of Care: Patient Safety Birth-related trauma, neonates and mothers |
Birth trauma to neonate, per 1,000 live births | 2.1 | x | 114a |
| Obstetric trauma—cesarean delivery (ages 10-14, 15-17) | 2.22 | x | x | |
| Obstetric trauma—per 1,000 instrument-assisted deliveries (ages 10-14, 15-17) | x | x | 115a | |
| Obstetric trauma—per 1,000 vaginal deliveries without instrument assistance (ages 10-14, 15-17) | x | x | 116a | |
Quality of Care: Patient Safety Potentially avoidable deaths |
Deaths per 1,000 admissions in low mortality DRGs (ages 0-17), some exclusions | 2.2 | x | 118a |
| Failure to rescue or deaths per 1,000 discharges having developed specified complications of care during hospitalization (excluding patients transferred in or out, patients admitted from long-term care facilities, neonates, and patients over 74 years old), (ages 0-17) | 2.3 | x | 119a | |
Quality of Care: Patient Safety Transfusion reactions |
Transfusion reactions per 1,000 discharges (excluding neonates) (ages 0-17) | 2.4a | x | x |
| Transfusion reactions per 100,000 population (excluding neonates) (ages 0-17) | 2.4b | x | x | |
Quality of Care: Patient Safety Nosocomial infections |
Selected infections due to medical care per 1,000 discharges (ages 0-17) | 2.11a | x | 101a |
| Selected infections due to medical care per 100,000 population (ages 0-17) | 2.11b | x | x | |
| Ventilator-associated pneumonia in infants weighing ‹1,000 grams at birth in intensive care, per 1,000 days of use | 2.25 | x | x | |
| Central line-associated bloodstream infection in infants weighing 1,000 grams or less at birth in intensive care, per 1,000 days of use | 2.7 | x | x | |
| Postoperative sepsis per 1,000 elective-surgery discharges of longer than 3 days (excluding obstetric conditions, others) (ages 0-17) | 2.17 | x | x | |
Quality of Care: Patient Safety Complications of care |
Foreign body left in body during procedure per 1,000 discharges (excluding neonates) (ages 0-17) | 2.5a | x | 113a |
| Foreign body left in body during procedure per 100,000 population (excluding neonates) (ages 0-17) | 2.5b | x | x | |
| Complications of anesthesia per 1,000 surgical discharges (ages 0-17) | 2.8 | x | x | |
| Decubitus ulcers per 1,000 discharges of length 5 or more days (excluding obstetrical patients and others) (ages 0-17) | 2.9 | x | 108a | |
Quality of Care: Patient Safety Injuries or adverse events due to technical errors |
Iatrogenic pneumothorax per 1,000 discharges (excluding neonates and obstetric admissions, others) (ages 0-17) | 2.10a | x | 111a |
| Iatrogenic pneumothorax per 100,000 population (excluding neonates and obstetric admissions, others) (0-17) | 2.10b | x | x | |
| Accidental puncture or laceration during procedures per 1,000 discharges (excluding obstetric admissions) (ages 0-17) | 2.18a | x | 110a | |
| Accidental puncture or laceration during procedures per 100,000 population (excluding obstetric admissions) (ages 0-17) | 2.18b | x | x | |
| Postoperative hemorrhage or hematoma per 1,000 surgical discharges (excluding obstetric admissions) (ages 0-17) | 2.13 | x | 103a | |
| Postoperative physiologic and metabolic derangements per 1,000 elective surgical discharges (excluding obstetric admissions, others) (ages 0-17) | 2.14 | x | 106a | |
| Postoperative respiratory failure per 1,000 elective surgical discharges (excluding obstetric conditions, others) (ages 0-17) | 2.15 | x | 105a | |
| Postoperative pulmonary embolism or deep vein thrombosis per 1,000 surgical discharges (excluding obstetrics, others) (ages 0-17) | 2.16 | x | 104a | |
| Postoperative abdominal wound dehiscence per 1,000 abdominopelvic surgery discharges (excluding obstetric conditions) (ages 0-17) | 2.19a | x | 112a | |
| Postoperative abdominal wound dehiscence per 100,000 population (excluding obstetrics) (ages 0-17) | 2.19b | x | x | |
Quality of Care: Timeliness Getting an appointment as soon as wanted |
Among children under age 18 who had appointments reported for routine health care in the last 12 months, percent distribution of how often they got an appointment as soon as wanted | 3.4a | 3.4b, 3.4c | 225A a,b,c 225B a,b,c 225C a,b,c |
| Among children under age 18 who had appointments reported for an illness or injury in the last 12 months, percent distribution of how often they got an appointment as soon as wanted | 3.6a | 3.6b, 3.6c | 226A a,b,c 226B a,b,c 226C a,b,c |
|
Quality of Care: Timeliness Emergency department (ED) waits |
ED visits: Percent ED visits where patient was admitted to the hospital or transferred to other facility whose ED visit was greater than or equal to six hours (ages 0-17) | 3.7 | x | x |
| ED visits: Percent of patients who left without being seen | 3.8 | x | x | |
Quality of Care: Patient Centeredness |
Among children under age 18 who had a doctor's office or clinic visit in the last 12 months, percent distribution of how often their health providers spent enough time with them and their parents | 4.8a | x | 231A a,b,c 231B a,b,c 231C a,b,c |
| Among children under age 18 who had a doctor's office or clinic visit in the last 12 months, percent distribution of how often their health providers explained things in a way that parents could understand | x | x | 229A a,b,c 229B a,b,c 229C a,b,c |
|
| Among children under age 18 who had a doctor's office or clinic visit in the last 12 months, percent distribution of how often their health providers showed respect for what parents had to say | x | x | 230A a,b,c 230B a,b,c 230C a,b,c |
|
| Among children under age 18 who had a doctor's office or clinic visit reported in the last 12 months, percent distribution of how often their health care providers listened carefully to their parents | 4.2avii | x | 228A a,b,c 228B a,b,c 228C a,b,c |
|
| Children with special health care needs without family-centered care (ages 0-5, 6-11, 12-17) | x | x | 237a,b,c | |
Quality of Care: Overall Measures |
Among children under age 18 who had a doctor's office or clinic visit in the last 12 months, distribution of parents ratings for health care received | 5.2a | 5.2b | 232A,B,C |
Access to Careviii: Getting into the Health Care System Health insurance coverage |
People under age 65 with health insurance (ages 0-17) | x | x | 120a,b,c |
| People under age 65 with public health insurance only (ages 0-17) | x | x | 121a,b,c | |
| People under age 65 with any private health insurance (ages 0-17) | x | x | 122a,b,c | |
| People uninsured all year (ages 0-17) | x | x | 124a,b,c | |
| Children with special health care needs without health insurance at some point in past year) (ages 0-5, 6-11, 12-17) | x | x | 238a,b,c | |
| Children with special health care needs with insurance that is not adequate (ages 0-5, 6-11, 12-17) | x | x | 239a,b,c | |
Access to Careviii: Getting into the Health Care System Usual source of care |
People who have a specific source of ongoing care (ages 0-17) | 3.1a | x | 127a,b,c |
| People in fair or poor health who have a specific source of ongoing care (ages 0-17) | x | x | 128a,b,c | |
| People with a hospital, emergency room, or clinic as source of ongoing care (ages 0-17) | x | x | 129a,b,c | |
| People without a usual source of care who indicate a financial or insurance reason for not having a source of care (ages 0-17) | x | x | 131a,b,c | |
| People who have a usual primary care provider (ages 0-17) | x | x | 132a,b,c | |
| People in community health centers who have a usual source of care (ages 0-17) | x | x | 223a,b,c | |
| Children with special health care needs with no usual source of care (ages 0-5, 6-11, 12-17) | x | x | 240a,b,c | |
Access to Careviii: Getting Care Within the Health Care System |
People with provider who has office hours nights or weekends (ages 0-17) | x | x | 141a,b,c |
| People with difficulty getting appointments on short notice (ages 0-17) | x | x | 142a,b,c | |
| People with difficulty contacting provider over the telephone (ages 0-17) | x | x | 143a,b,c | |
| People not very satisfied with professional staff at provider's office (ages 0-17) | x | x | 145a,b,c | |
| People who usually wait › 30 minutes before seeing provider (ages 0-17) | x | x | 146a,b,c | |
| Emergency/urgent emergency department visits with wait ›= 1 hour (ages 0-17) | x | x | 147a | |
| Semi-urgent/non-urgent emergency department visits with wait > = 1 hour (ages 0-17) | x | x | 148a | |
| Emergency department visits in which the patient left without being seen (ages 0-17) | x | x | 149a | |
| Children with special health care needs with unmet need for specific health care services (ages 0-5, 6-11, 12-17) | x | x | 241a,b,c | |
| Children with special health care needs needing specialty care who had difficulty getting referral in past year (ages 0-5, 6-11, 12-17) | x | x | 242a,b,c | |
Access to Careviii: Patient Perceptions of Care |
People with provider who usually asks about medications and treatments other doctors may give (ages 0-17) | x | x | 150a,b,c |
| People not satisfied with quality of care received from provider | x | x | 155a,b,c | |
Access to Careviii: Health Care Utilizationix General medical care |
People with an office or outpatient visit in the past year (ages 0-17) | x | x | 171a,b,c |
| People with a prescription medication in the past year (ages 0-17) | x | x | 172a,b,c | |
| People with a dental visit in the past year (ages 0-17) | x | x | 173a,b,c | |
| People with an emergency room visit in the past year (ages 0-17) | x | x | 174a,b,c | |
| People with an inpatient discharge in the past year (ages 0-17) | x | x | 175a,b,c | |
| Outpatient visits per 100 population (ages 0-17) | x | x | 176a | |
| Emergency department visits per 100 population (ages 0-17) | x | x | 177a | |
| Total hospitalizations per 100 population (ages 0-17) | x | x | 178a | |
Access to Careviii: Health Care Utilizationix Avoidable admissions |
Bacterial pneumonia hospital admissions per 100,000 population (excluding sickle cell or hemoglobin-S condition, transfers from other institutions, and obstetric and neonatal admissions), by race (ages 0-17) | x | x | 190a |
| Hospital admissions with perforated appendices per 1,000 admissions with appendicitis (ages 0-17) | x | x | 191a | |
Access to Careviii: Health Care Utilizationix Mental health care and substance abuse treatment |
People age 12 and older who received illicit drug or alcohol abuse treatment in the past year (ages 12-17) | x | x | 197a,b |
| People age 12 and older who needed treatment at a specialty facility for illicit drug use and who received such treatment in the past year (ages 12-17) | x | x | 198a,b | |
| Inpatient admissions to specialty mental health organizations per 100,000 population (age ‹ 18) | x | x | 199a,b | |
| Residential care admissions to specialty mental health organizations per 100,000 population (age ‹ 18) | x | x | 200a,b | |
| ‹ 24 hour care admissions to specialty mental health organizations per 100,000 population (age ‹ 18) | x | x | 201a,b | |
Access to Careviii: Health Care Utilizationix Ambulatory care |
Outpatient visits where patient was seen before in clinic or practice (ages 0-17) | x | x | 207a |
| Outpatient visits where patient was seen by patient's primary care provider (ages 0-1 | x | x | 208a | |
| Outpatient visits where patient was seen for non-illness care (ages 0-17) | x | x | 209a | |
| Outpatient visits with counseling or education about diet and nutrition (ages 0-17) | x | x | 210a | |
| Outpatient visits with counseling or education about exercise (ages 0-17) | x | x | 211a | |
| Outpatient visits with counseling or education about tobacco use and exposure (ages 0-17) | x | x | 212a | |
| Outpatient visits where physician spent more than 30 minutes with patient (ages 0-17) | x | x | 213a | |
| Outpatient visits where patient was referred by another physician or health plan (ages 0-17) | x | x | 214a | |
| Outpatient visits where patient was referred to another physician (ages 0-17) | x | x | 215a | |
| Emergency department visits related to injuries per 10,000 population (ages 0-17) | x | x | 216a | |
| Emergency department visits for asthma per 10,000 population (ages 0-17) | x | x | 217a | |
| Emergency department visits where patient was seen by intern/resident only (ages 0-17 | x | x | 218a |
Key: x = no data or no child data reported.
iNHQR and NHDR tables and full text of the reports are available at: www.qualitytools.ahrq.gov/
iiThe NHDR contains information on children by race, ethnicity, and/or income, as available.
iiiIn each report, quality measures are grouped in 4 major domains of quality: Effectiveness, Safety, Timeliness, and Patient Centeredness.
ivEffectiveness of care measures in each report are organized primarily by disease (cancer, diabetes, end stage renal disease, heart disease, HIV and AIDS, mental health, respiratory diseases). In addition there are sections for maternal and child health, and nursing home and home health care.
vThe age group(s) in parentheses is the child/adolescent age group for which there are data in the respective table.
viFor reports on other preventable hospitalizations, see NHDR table 220 (Admissions for bacterial pneumonia per 100,000 in Indian Health Service hospitals), NHQR tables 1.93a and 1.93b (hospital admissions for pediatric asthma) and NHDR table 76 (hospital admissions for asthma per 100,000 population under age 18).
viiBy whether child had a special health care need.
viiiIn addition to the inclusion of quality measures, the NHDR also includes data on access to care.
ixIn addition to the inclusion of quality measures, the NHDR also includes data on health care utilization.
Current as of March 2005
Internet Citation:
List of Measures: NHQR and NHDR Appendix Tables With Information on Child and Adolescent Health Care Quality and Access. March 2005. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/qual/nhqrdrchapp.htm
Return to Quality Assessment
AHRQ Home Page
Department of Health and Human Services