Receipt of Recommended Interventions for Pneumonia by the Elderly

The Centers for Medicare & Medicaid Services (CMS) tracks a set of measures for quality of pneumonia care for hospitalized adults age 65 and older through the CMS Quality Improvement Organization (QIO) Program.

Figure 2.20. Percent of pneumonia patients 65 and older who had blood cultures before antibiotics, who received their initial dose of antibiotics within 4 hours of admission, and who received antibiotics consistent with current recommendations, 2002

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Source: Centers for Medicare & Medicaid Services, Quality Improvement Organization Program, 2002.

• The percentage of pneumonia discharges for patients 65 and older who had blood cultures before antibiotics was 81%; the percentage who received their initial dose of antibiotics within 4 hours of admission was 63.1%; and the percentage who received antibiotics consistent with current recommendations was 67.9% (Figure 2.20).
• The percentage of pneumonia discharges for patients age 65 and older who received all of the above interventions was 29.9%.

Hospital Admissions for Pediatric Asthma

Asthma can be effectively controlled over the long term with recommended medications. Preventing hospital admissions for asthma is one measure of successful management of asthma at the population level.

Figure 2.21. State variation in pediatric hospital admissions for asthma per 100,000 population, 2001

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Source: Agency for Healthcare Research and Quality, HCUP State Inpatient Databases, 2001.

Note: Not all States are included. Values for quartiles are: 0-25th percentile = 221.4-315.3 admissions/100,000 population; >25th-50th percentile = 187.3-220.9; >50th-75th percentile = 125.6-176.6; >75th-100th percentile = 66.3-120.6.

• Child asthma admission rates vary from 98 admissions per 100,000 population for the best performing quartile of States to 261.5 admissions per 100,000 population for the lowest performing quartile of States'a difference of 167% (Figure 2.21).
• While prevalence rates vary by age, admission rates nationally for children are more than twice those for adults'26.2 admissions for children per 100,000 population in 2001 vs. 12.5 admissions for adults per 100,000 population (National Hospital Discharge Survey, 2001; see Tables Appendix, Tables 1.93a, 1.94a).
• According to health plan performance data, on average, 67.9% of patients get proper medication for long-term control of asthmaⁱ (National Committee for Quality Assurance, 2002; see Tables Appendix, Table 1.92).

ⁱPercentage refers to patients commercially insured. The percentage of Medicaid patients for this same measure is 61.6%.