List of Measures

National Healthcare Quality Report, 2003

The National Healthcare Disparities Report (NHDR) tracks disparities in both quality of and access to health care in the United States for both the general population and for AHRQ's congressionally designated priority populations. This is the text version of the NHDR 2008 slide presentation.

List of Measures

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:

2003 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
   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

Getting Into the Health Care System

Topic	Measure	National Database^a
Health Insurance Coverage	People under 65 with health insurance^b	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 care^b	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 provider^b	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 care^b	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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Getting Care Within the System

Topic	Measure	National Database^a
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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Patient Perceptions of Their Care

Topic	Measure	National Database^a
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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Health Care Utilization

Topic	Measure	National Database^a
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
Referred Care	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 population^b	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

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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)
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 September 2010

Internet Citation: List of Measures: National Healthcare Quality Report, 2003. September 2010. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/research/findings/nhqrdr/nhdr03/listmeasure.html