Appendix F: NHQR Quality Measures for All Conditions by State

Diabetes Care Quality Improvement: A Resource Guide for State Action

This appendix lists quality measures for all conditions and topics in the NHQR. It includes the national estimate and then an indicator for whether or not the State estimate (not shown due to space limitation) is statistically greater, lower, or no different from the national average. The measures for which State-level data are not reported in the NHQR are noted as not available (n/a). This resource can help States identify which diseases and treatments, including and outside of diabetes, may be in need of attention. Many of the same data issues described in Module 2: Data and Module 3: Information are applicable to other disease topics, although different data sources and limitations may apply to them.

Table F.1. NHQR quality measures for all conditions when available by State, alphabetically Alabama through Missouri
Table F.2. NHQR quality measures for all conditions when available by State, alphabetically Montana through Wyoming

Table F.1. NHQR quality measures for all conditions when available by State, alphabetically Alabama through Missouri

Part 1 - Alabama-Florida

National Healthcare Quality Report (2003) Measures, National Estimate, and State Significance Test (Sig.)^a for Difference from the National Average

Measure Title	Year	Metric	U.S. Est.	AL Sig.	AK Sig.	AZ Sig.	AR Sig.	CA Sig.	CO Sig.	CT Sig.	DE Sig.	DC Sig.	FL Sig.	Source	NHQR Table
1. Effectiveness of Care
Cancer
Screening for breast cancer
Process: Percent of women (age 40 and over) who report they had a mammogram within the past 2 years	2001	Percent	76.00	n/a	n/a	ns	-	n/a	ns	n/a	n/a	n/a	n/a	BRFSS	1.1b
	2000	Percent	76.70	ns	ns	+	-	ns	ns	+	+	+	ns	BRFSS	1.1c
Screening for cervical cancer:
Process: Percent of women (age 18 and over) who report that they had a Pap smear within the past 3 years	2001	Percent	84.80	n/a	n/a	ns	-	n/a	ns	n/a	n/a	n/a	n/a	BRFSS	1.3b
	2000	Percent	83.70	ns	+	ns	-	ns	ns	+	+	+	ns	BRFSS	1.3c
Screening for colorectal cancer:
Process: Percent of men and women (age 50 and over) who report they ever had a flexible sigmoidoscopy/colonoscopy	2001	Percent	47.60	ns	ns	ns	-	ns	ns	+	+	+	ns	BRFSS	1.5b
Process: Percent of men and women (age 50 and over) who report they had a fecal occult blood test (FOBT) within the past 2 years	2001	Percent	35.30	-	-	ns	-	ns	ns	+	-	+	+	BRFSS	1.6b
Chronic Kidney Disease
Management of End Stage Renal Disease:
Process: Percent of dialysis patients registered on waiting list for transplantation^d	2000	Percent	21	ns	ns	-	-	+	+	ns	+	-	-	USRDS	1.15b
Process: Percent of patients with treated chronic kidney failure who receive a transplant within three years of renal failure^e-h	1997	Percent	20	ns	ns	ns	ns	-	+	ns	ns	-	ns	USRDS	1.16b
Diabetes
Management of Diabetes:
Percent of adults with diabetes who had a hemoglobin A1c measurement at least once in the past year	2001	Percent	79.4	ns	n/a	ns	ns	ns	ns	+	n/a	ns	ns	BRFSS	1.20c
Management of Diabetes:
Percent of adults with diabetes who had a retinal eye examination in past year	2001	Percent	66.7	ns	n/a	ns	ns	ns	ns	+	n/a	ns	ns	BRFSS	1.22b
Percent of adults with diabetes who had a foot examination in past year	2001	Percent	64.6	ns	n/a	ns	-	ns	-	ns	n/a	ns	ns	BRFSS	1.23b
Percent of adults with diabetes who had an influenza immunization in past year	2001	Percent	37.4	ns	n/a	-	ns	ns	-	ns	ns	ns	ns	BRFSS	1.24b
Heart Disease
Screening for high cholesterol:
Process: Percent of adults 18 and over receiving cholesterol measurement within 5 years	2001	Percent	73	ns	-	ns	-	-	ns	+	+	+	+	BRFSS	1.32b
Counseling on risk factors:
Process: Percent of smokers (age 18 and over) receiving advice to quit smoking	2001	Percent	71	n/a	ns	ns	ns	n/a	n/a	-	ns	n/a	n/a	BRFSS	1.33b
Treatment of AMI:
Process: Percent of AMI patients administered aspirin within 24 hours of admission^j	2000-2001	Percent	85	-	ns	ns	-	ns	+	ns	ns	ns	-	QIO	1.34b^jj
Process: Percent of AMI patients with aspirin prescribed at discharge^j	2000-2001	Percent	86	ns	ns	ns	ns	ns	+	ns	+	+	-	QIO	1.35b^jj
Process: Percent of AMI patients administered beta blocker within 24 hours of admission^j	2000-2001	Percent	69	-	ns	ns	-	ns	ns	+	ns	ns	ns	QIO	1.36b^jj
Process: Percent of AMI patients with beta blocker prescribed at discharge^j	2000-2001	Percent	79	ns	ns	ns	-	-	+	ns	ns	ns	ns	QIO	1.37b^jj
Process: Percent of AMI patients with left ventricular systolic dysfunction prescribed ACE inhibitor at discharge^j	2000-2001	Percent	74	ns	+	ns	ns	ns	ns	ns	ns	ns	-	QIO	1.38b^jj
Process: Percent of AMI patients given smoking cessation counseling while hospitalized^j	2000-2001	Percent	43	ns	ns	ns	ns	-	ns	ns	ns	ns	ns	QIO	1.39b^jj
Process: Median Time to thrombolysis. Time on arrival to initiation of a thrombolytic agent patients with ST segment elevation or left branch block (LBBB) on the electrocardiogram (ECG) performed closest to hospital arrival time^j-k	1999-2000	Median	62	-	ns	ns	ns	ns	ns	ns	+	n/a	ns	QIO	1.40b^jj
Process: Median time to PTCA. Median time from arrival to percutaneous transluminal angioplasty (PTCA) in patients with ST segment elevation or left bundle branch block (LBBB) on the electrocardiogram (ECG) performed closest to hospital arrival time.^j, ^l	1999-2000	Median	186	ns	+	+	+	ns	ns	+	+	ns	ns	QIO	1.41b^jj
Treatment of acute heart failure:
Process: Percent of heart failure patients having evaluation of left ventricular ejection fraction^j	2000-2001	Percent	69	ns	ns	+	-	ns	ns	+	+	ns	+	QIO	1.42b^jj
Process: Percent of heart failure patients with left ventricular systolic dysfunction prescribed ACE inhibitor at discharge^j	2000-2001	Percent	66	ns	ns	ns	-	ns	ns	ns	+	ns	ns	QIO	1.43b^jj

Part 2: Georgia-Kansas

Measure Title	Year	Metric	U.S. Est.	GA Sig.	HI Sig.	ID Sig.	IL Sig.	IN Sig.	IA Sig.	KS Sig.	Source	NHQR Table
1. Effectiveness of Care
Cancer
Screening for breast cancer
Process: Percent of women (age 40 and over) who report they had a mammogram within the past 2 years	2001	Percent	76.00	+	+	n/a	n/a	n/a	n/a	n/a	BRFSS	1.1b
	2000	Percent	76.70	ns	ns	-	ns	-	ns	ns	BRFSS	1.1c
Screening for cervical cancer:
Process: Percent of women (age 18 and over) who report that they had a Pap smear within the past 3 years	2001	Percent	84.80	+	+	n/a	n/a	n/a	n/a	n/a	BRFSS	1.3b
	2000	Percent	83.70	+	+	-	-	ns	ns	ns	BRFSS	1.3c
Screening for colorectal cancer:
Process: Percent of men and women (age 50 and over) who report they ever had a flexible sigmoidoscopy/colonoscopy	2001	Percent	47.60	ns	ns	-	-	ns	ns	-	BRFSS	1.5b
Process: Percent of men and women (age 50 and over) who report they had a fecal occult blood test (FOBT) within the past 2 years	2001	Percent	35.30	ns	+	-	+	-	ns	ns	BRFSS	1.6b
Chronic Kidney Disease
Management of End Stage Renal Disease:
Process: Percent of dialysis patients registered on waiting list for transplantation^d	2000	Percent	21	-	ns	ns	+	-	+	ns	USRDS	1.15b
Process: Percent of patients with treated chronic kidney failure who receive a transplant within three years of renal failure^e-h	1997	Percent	20	-	ns	+	+	ns	+	ns	USRDS	1.16b
Diabetes
Management of Diabetes:
Percent of adults with diabetes who had a hemoglobin A1c measurement at least once in the past year	2001	Percent	79.4	ns	+	+	n/a	n/a	ns	ns	BRFSS	1.20c
Management of Diabetes:
Percent of adults with diabetes who had a retinal eye examination in past year	2001	Percent	66.7	ns	ns	-	n/a	n/a	+	ns	BRFSS	1.22b
Percent of adults with diabetes who had a foot examination in past year	2001	Percent	64.6	ns	+	ns	n/a	n/a	ns	ns	BRFSS	1.23b
Percent of adults with diabetes who had an influenza immunization in past year	2001	Percent	37.4	ns	+	ns	ns	ns	+	ns	BRFSS	1.24b
Heart Disease
Screening for high cholesterol:
Process: Percent of adults 18 and over receiving cholesterol measurement within 5 years	2001	Percent	73	+	+	-	-	ns	-	-	BRFSS	1.32b
Counseling on risk factors:
Process: Percent of smokers (age 18 and over) receiving advice to quit smoking	2001	Percent	71	n/a	n/a	n/a	n/a	ns	n/a	n/a	BRFSS	1.33b
Treatment of AMI:
Process: Percent of AMI patients administered aspirin within 24 hours of admission^j	2000-2001	Percent	85	-	+	+	ns	ns	ns	ns	QIO	1.34b^jj
Process: Percent of AMI patients with aspirin prescribed at discharge^j	2000-2001	Percent	86	ns	ns	ns	-	ns	ns	ns	QIO	1.35b^jj
Process: Percent of AMI patients administered beta blocker within 24 hours of admission^j	2000-2001	Percent	69	-	ns	ns	ns	ns	+	ns	QIO	1.36b^jj
Process: Percent of AMI patients with beta blocker prescribed at discharge^j	2000-2001	Percent	79	ns	ns	ns	ns	ns	+	ns	QIO	1.37b^jj
Process: Percent of AMI patients with left ventricular systolic dysfunction prescribed ACE inhibitor at discharge^j	2000-2001	Percent	74	ns	ns	ns	ns	ns	ns	ns	QIO	1.38b^jj
Process: Percent of AMI patients given smoking cessation counseling while hospitalized^j	2000-2001	Percent	43	ns	ns	ns	ns	+	ns	ns	QIO	1.39b^jj
Process: Median Time to thrombolysis. Time on arrival to initiation of a thrombolytic agent patients with ST segment elevation or left branch block (LBBB) on the electrocardiogram (ECG) performed closest to hospital arrival time^j-k	1999-2000	Median	62	ns	ns	+	ns	ns	ns	ns	QIO	1.40b^jj
Process: Median time to PTCA. Median time from arrival to percutaneous transluminal angioplasty (PTCA) in patients with ST segment elevation or left bundle branch block (LBBB) on the electrocardiogram (ECG) performed closest to hospital arrival time.^j, ^l	1999-2000	Median	186	n/a	+	+	ns	ns	+	ns	QIO	1.41b^jj
Treatment of acute heart failure:
Process: Percent of heart failure patients having evaluation of left ventricular ejection fraction^j	2000-2001	Percent	69	ns	+	-	ns	ns	ns	-	QIO	1.42b^jj
Process: Percent of heart failure patients with left ventricular systolic dysfunction prescribed ACE inhibitor at discharge^j	2000-2001	Percent	66	ns	ns	ns	ns	ns	ns	ns	QIO	1.43b^jj

Part 3- Kentucky to Missouri

Measure Title	Year	Metric	U.S. Est.	KY Sig.	LA Sig.	ME Sig.	MD Sig.	MA Sig.	MI Sig.	MN Sig.	MS Sig.	MO Sig.	Source	NHQR Table
1. Effectiveness of Care
Cancer
Screening for breast cancer
Process: Percent of women (age 40 and over) who report they had a mammogram within the past 2 years	2001	Percent	76.00	n/a	n/a	n/a	n/a	n/a	n/a	n/a	-	n/a	BRFSS	1.1b
	2000	Percent	76.70	ns	ns	ns	+	+	+	-	-	ns	BRFSS	1.1c
Screening for cervical cancer:
Process: Percent of women (age 18 and over) who report that they had a Pap smear within the past 3 years	2001	Percent	84.80	n/a	n/a	n/a	n/a	n/a	n/a	n/a	ns	n/a	BRFSS	1.3b
	2000	Percent	83.70	ns	ns	ns	+	+	ns	ns	ns	ns	BRFSS	1.3c
Screening for colorectal cancer:
Process: Percent of men and women (age 50 and over) who report they ever had a flexible sigmoidoscopy/colonoscopy	2001	Percent	47.60	-	-	ns	+	+	+	+	-	-	BRFSS	1.5b
Process: Percent of men and women (age 50 and over) who report they had a fecal occult blood test (FOBT) within the past 2 years	2001	Percent	35.30	-	-	+	+	+	ns	ns	-	-	BRFSS	1.6b
Chronic Kidney Disease
Management of End Stage Renal Disease:
Process: Percent of dialysis patients registered on waiting list for transplantation^d	2000	Percent	21	-	-	ns	+	+	+	+	-	ns	USRDS	1.15b
Process: Percent of patients with treated chronic kidney failure who receive a transplant within three years of renal failure^e-h	1997	Percent	20	+	-	ns	+	+	ns	+	-	+	USRDS	1.16b
Diabetes
Management of Diabetes:
Percent of adults with diabetes who had a hemoglobin A1c measurement at least once in the past year	2001	Percent	79.4	+	n/a	ns	n/a	ns	ns	+	n/a	n/a	BRFSS	1.20c
Management of Diabetes:
Percent of adults with diabetes who had a retinal eye examination in past year	2001	Percent	66.7	ns	n/a	+	n/a	ns	ns	ns	n/a	n/a	BRFSS	1.22b
Percent of adults with diabetes who had a foot examination in past year	2001	Percent	64.6	ns	n/a	ns	n/a	ns	ns	+	n/a	n/a	BRFSS	1.23b
Percent of adults with diabetes who had an influenza immunization in past year	2001	Percent	37.4	ns	-	ns	ns	ns	-	ns	-	ns	BRFSS	1.24b
Heart Disease
Screening for high cholesterol:
Process: Percent of adults 18 and over receiving cholesterol measurement within 5 years	2001	Percent	73	ns	ns	+	+	+	ns	+	-	-	BRFSS	1.32b
Counseling on risk factors:
Process: Percent of smokers (age 18 and over) receiving advice to quit smoking	2001	Percent	71	ns	+	+	n/a	n/a	n/a	n/a	ns	ns	BRFSS	1.33b
Treatment of AMI:
Process: Percent of AMI patients administered aspirin within 24 hours of admission^j	2000-2001	Percent	85	ns	ns	+	ns	ns	ns	ns	-	ns	QIO	1.34b^jj
Process: Percent of AMI patients with aspirin prescribed at discharge^j	2000-2001	Percent	86	ns	-	+	ns	ns	ns	ns	ns	ns	QIO	1.35b^jj
Process: Percent of AMI patients administered beta blocker within 24 hours of admission^j	2000-2001	Percent	69	ns	ns	+	ns	+	ns	+	-	ns	QIO	1.36b^jj
Process: Percent of AMI patients with beta blocker prescribed at discharge^j	2000-2001	Percent	79	ns	ns	+	ns	+	+	ns	-	ns	QIO	1.37b^jj
Process: Percent of AMI patients with left ventricular systolic dysfunction prescribed ACE inhibitor at discharge^j	2000-2001	Percent	74	ns	ns	ns	ns	ns	+	ns	ns	ns	QIO	1.38b^jj
Process: Percent of AMI patients given smoking cessation counseling while hospitalized^j	2000-2001	Percent	43	ns	-	ns	-	ns	ns	ns	ns	+	QIO	1.39b^jj
Process: Median Time to thrombolysis. Time on arrival to initiation of a thrombolytic agent patients with ST segment elevation or left branch block (LBBB) on the electrocardiogram (ECG) performed closest to hospital arrival time^j-k	1999-2000	Median	62	+	ns	ns	+	ns	ns	+	ns	ns	QIO	1.40b^jj
Process: Median time to PTCA. Median time from arrival to percutaneous transluminal angioplasty (PTCA) in patients with ST segment elevation or left bundle branch block (LBBB) on the electrocardiogram (ECG) performed closest to hospital arrival time.^j, ^l	1999-2000	Median	186	n/a	ns	n/a	ns	ns	+	ns	ns	ns	QIO	1.41b^jj
Treatment of acute heart failure:
Process: Percent of heart failure patients having evaluation of left ventricular ejection fraction^j	2000-2001	Percent	69	-	ns	ns	+	+	ns	ns	-	ns	QIO	1.42b^jj
Process: Percent of heart failure patients with left ventricular systolic dysfunction prescribed ACE inhibitor at discharge^j	2000-2001	Percent	66	-	ns	ns	ns	ns	ns	ns	-	ns	QIO	1.43b^jj

Page last reviewed August 2008

Internet Citation: Appendix F: NHQR Quality Measures for All Conditions by State: Diabetes Care Quality Improvement: A Resource Guide for State Action. August 2008. Agency for Healthcare Research and Quality, Rockville, MD. http://archive.ahrq.gov/professionals/quality-patient-safety/quality-resources/tools/diabguide/diabqguideapf.html

Appendix F: NHQR Quality Measures for All Conditions by State

Diabetes Care Quality Improvement: A Resource Guide for State Action

Contents

Table F.1. NHQR quality measures for all conditions when available by State, alphabetically Alabama through Missouri