Chapter 2. Quality of Health Care (continued, 5)

National Healthcare Disparities Report, 2009


Summary Tables

Table 2.1a. Racial and Ethnic Differences in Effectiveness of Care

Core Report MeasureRacial DifferenceiEthnic Differenceii
BlackAsianNHOPIAI/ANMore than 1 RaceHispanic
Cancer
Women age 40 and over who reported they had a mammogram within the past 2 yearsiii= ==
Breast cancer incidence per 100,000 women age 40 and over diagnosed at advanced stageiv 
Breast cancer deaths per 100,000 female population per year 
Adults age 50 and over who received a sigmoidoscopy, colonoscopy, or proctoscopy or fecal occult blood test in the last 2 yearsiii =
Colorectal cancer diagnosed at advanced stageiv 
Colorectal cancer deaths per 100,000 population per yearv 
Diabetes
Composite: Adults with diabetes who had hemoglobin A1c measurement, dilated eye exam, and foot exam in the calender yearvi=    
End Stage Renal Disease
Adult hemodialysis patients with adequate dialysisvii=  
Dialysis patients under age 70 who were registered on a waiting list for transplantationviii= = =

i Compared with Whites.
ii Compared with non-Hispanic Whites.
iii Source: National Health Interview Survey, 2005.
iv Source: Surveillance, Epidemiology, and End Results Program, 2006. This source does not provide rate estimates for Asians and NHOPIs separately but in aggregate as Asian and Pacific Islander. This source did not collect information for More than 1 Race.
v Source: National Vital Statistics System-Mortality, 2006. This source did not collect information on Asians and NHOPIs separately but in aggregate as Asian and Pacific Islander. This source did not collect information for More than 1 Race.
vi Source: Medical Expenditure Panel Survey, 2005.
vii Source: CMS End Stage Renal Disease Clinical Performance Measures Project, 2007.
viii U.S. Renal Data System, 2005. This source did not collect information on Asians and NHOPIs separately but in aggregate as Asian and Pacific Islander. This source did not collect information for More than 1 Race.
Key: NHOPI=Native Hawaiian or Other Pacific Islander; AI/AN=American Indian or Alaska Native.

Table 2.1a. Racial and Ethnic Differences in Effectiveness of Care (continued)

Core Report MeasureRacial DifferenceiEthnic Differenceii
BlackAsianNHOPIAI/ANMore than 1 RaceHispanic
Heart Disease
Composite: Hospital patients with heart attack who received recommended hospital careiii== = 
Deaths per 1,000 adult hospital admissions with acute myocardial infarctioniv   =
Composite: Hospital patients with heart failure who received recommended hospital careiii=  

i Compared with Whites.
ii Compared with non-Hispanic Whites.
iii Source: CMS Quality Improvement Organization Program, 2007. This source categorizes race/ethnicity information as a single item: non-Hispanic White, non-Hispanic Black, Hispanic, Asian and Pacific Islander, American Indian and Alaska Native. These contrasts compare each group with non-Hispanic Whites.
iv Source: HCUP State Inpatient Databases disparities analysis file, 2006. This source categorizes race/ethnicity information as a single item: non-Hispanic White, non-Hispanic Black, Hispanic, Asian and Pacific Islander. These contrasts compare each group with non-Hispanic Whites.

Key: NHOPI=Native Hawaiian or Other Pacific Islander; AI/AN=American Indian or Alaska Native.

Key to Symbols Used in Quality of Health Care Tables:
= Group and comparison group receive about same quality of health care or have similar outcomes.
↑ Group receives better quality of health care than the comparison group or has better outcomes.
↓ Group receives poorer quality of health care than the comparison group or has worse outcomes.
Blank cell: Reliable estimate for group could not be made.

Table 2.1a. Racial and Ethnic Differences in Effectiveness of Care (continued)

Core Report MeasureRacial DifferenceiEthnic Differenceii
BlackAsianNHOPIAI/ANMore than 1 RaceHispanic
HIV and AIDS
New AIDS cases per 100,000 population age 13 and overiii= 
Maternal and Child Health
Children ages 19-35 months who received all recommended vaccinesiv= ===
Children ages 2-17 with advice about healthy eatingv==  ==
Children ages 3-6 who ever had their vision checkedv=    
Children ages 2-17 who had a dental visit in the past yearv=  
Children ages 2-17 with advice about physical activityv==  ==

i Compared with Whites.
ii Compared with non-Hispanic Whites.
iii Source: Centers for Disease Control and Prevention, 2007. This source categorizes race/ethnicity information as a single item: non-Hispanic White, non-Hispanic Black, Hispanic, Asian, Native Hawaiian and Other Pacific Islander, American Indian and Alaska Native. These contrasts compare each group with non-Hispanic Whites.
iv Source: National Immunization Survey, 2007.
v Source: Medical Expenditure Panel Survey, 2006.

Key: NHOPI=Native Hawaiian or Other Pacific Islander; AI/AN=American Indian or Alaska Native.

Key to Symbols Used in Quality of Health Care Tables:
= Group and comparison group receive about same quality of health care or have similar outcomes.
↑ Group receives better quality of health care than the comparison group or has better outcomes.
↓ Group receives poorer quality of health care than the comparison group or has worse outcomes.
Blank cell: Reliable estimate for group could not be made.

Table 2.1a. Racial and Ethnic Differences in Effectiveness of Care (continued)

Core Report MeasureRacial DifferenceiEthnic Differenceii
BlackAsianNHOPIAI/ANMore than 1 RaceHispanic
Mental Health and Substance Abuse
Adults with a major depressive episode in the last 12 months who received treatment for depression in the last 12 monthsiii    
Suicide deaths per 100,000 populationiv= 
People age 12 and over who needed treatment for illicit drug use or alcohol problem who received such treatmentiii=    =
Respiratory Diseases
Adults age 65 and over who ever received pneumococcal vaccinationv   
Composite: Hospital patients with pneumonia who received recommended hospital carevi  
Patients with tuberculosis who completed a curative course of treatment within 1 year of treatment initiationvii== 

i Compared with Whites.
ii Compared with non-Hispanic Whites.
iii Source: Substance Abuse and Mental Health Services Administration, National Survey on Drug Use and Health, 2007.
iv Source: National Vital Statistics System-Mortality, 2006. This source did not collect information on Asians and NHOPIs separately but in aggregate as Asian and Pacific Islander. This source did not collect information for More than 1 Race.
v Source: National Health Interview Survey, 2007.
vi Source: CMS Quality Improvement Organization Program, 2007. This source categorizes race/ethnicity information as a single item: non-Hispanic White, non-Hispanic Black, Hispanic, Asian and Pacific Islander, American Indian and Alaska Native. These contrasts compare each group with non-Hispanic Whites.
vii Source: CDC National TB Surveillance System, 2005. This source did not collect information on Asians and NHOPIs separately but in aggregate as Asian and Pacific Islander. This source did not collect information for More than 1 Race.

Key: NHOPI=Native Hawaiian or Other Pacific Islander; AI/AN=American Indian or Alaska Native.

Key to Symbols Used in Quality of Health Care Tables:
= Group and comparison group receive about same quality of health care or have similar outcomes.
↑ Group receives better quality of health care than the comparison group or has better outcomes.
↓ Group receives poorer quality of health care than the comparison group or has worse outcomes.
Blank cell: Reliable estimate for group could not be made.

Table 2.1a. Racial and Ethnic Differences in Effectiveness of Care (continued)

Core Report MeasureRacial DifferenceiEthnic Differenceii
BlackAsianNHOPIAI/ANMore than 1 RaceHispanic
Lifestyle Modification
Adults with obesity who ever received advice to exercise moreiii=   =
Adult current smokers who received advice to quit smokingiii=    
Adults with obesity who ever received advice about healthy eatingiii   =
Supportive and Palliative Care
Long-stay nursing home residents with physical restraintsiv 
High-risk long-stay nursing home residents with pressure soresiv= 
Short-stay nursing home residents with pressure soresiv== 
Functional Status Preservation and Rehabilitation
Adult home health care patients whose ability to walk or move around improvedv======
Adult home health care patients who were admitted to the hospitalv=

i Compared with Whites.
ii Compared with non-Hispanic Whites.
iii Medical Expenditure Panel Survey, 2006.
iv Source: CMS Minimum Data Set, 2007. This source categorizes race/ethnicity information as a single item: non-Hispanic White, non-Hispanic Black, Hispanic, Asian and Pacific Islander. Contrasts compare each group with non-Hispanic Whites.
v Source: CMS Outcome and Assessment Information Set, 2007.

Key: NHOPI=Native Hawaiian or Other Pacific Islander; AI/AN=American Indian or Alaska Native.

Key to Symbols Used in Quality of Health Care Tables:
= Group and comparison group receive about same quality of health care or have similar outcomes.
↑ Group receives better quality of health care than the comparison group or has better outcomes.
↓ Group receives poorer quality of health care than the comparison group or has worse outcomes.
Blank cell: Reliable estimate for group could not be made.

Table 2.1b. Socioeconomic Differences in Effectiveness of Care

Core Report MeasureIncome DifferenceiEducational DifferenceiiInsurance Differenceiii
<100%100-199%200-399%<HSHS GradUninsured
Cancer
Women age 40 and over who reported they had a mammogram within the past 2 yearsiv
Breast cancer incidence per 100,000 women age 40 and over diagnosed at advanced stagev      
Adults age 50 and over who received a sigmoidoscopy, colonoscopy, or proctoscopy or fecal occult blood test within the last 2 yearsiv
Colorectal cancer deaths per 100,000 population per yearvi    
Diabetes
Composite: Adults with diabetes who had hemoglobin A1c measurement, dilated eye exam, and foot exam in the calender yearvii==
Maternal and Child Health
Children ages 19-35 months who received all recommended vaccinesviii=   
Children ages 2-17 with advice about healthy eatingvii  
Children ages 3-6 who ever had their vision checkedvii  
Children ages 2-17 who had a dental visit in the past yearvii=  
Children ages 2-17 with advice about physical activityvii=  

i Compared with persons with family incomes 400% of Federal poverty thresholds or above.
ii Compared with persons with any college education.
iii Compared with persons under 65 with any private health insurance.
iv Source: National Health Interview Survey, 2005.
v Source: Surveillance, Epidemiology, and End Results Program, 2006.
vi Source: National Vital Statistics System-Mortality, 2006.
vii Source: Medical Expenditure Panel Survey, 2006.
viii Source: National Immunization Survey, 2007.

Key: HS=high school.

Table 2.1b. Socioeconomic Differences in Effectiveness of Care (continued)

Core Report MeasureIncome DifferenceiEducational DifferenceiiInsurance Differenceiii
<100%100-199%200-399%<HSHS GradUninsured
Mental Health and Substance Abuse
Adults with a major depressive episode in the last 12 months who received treatment for the depression in the last 12 monthsiv===== 
Suicide deaths per 100,000 populationv      
People age 12 and over who needed treatment for illicit drug use or alcohol problem who received such treatmentiv== 
Lifestyle Modification
Adults with obesity who ever received advice to exercise morevi
Adult current smokers who received advice to quit smokingvi=====
Adults with obesity who ever received advice about healthy eatingvi=
Respiratory Diseases
Adults age 65 and over who ever received pneumococcal vaccinationvii== 

i Compared with persons with family incomes 400% of Federal poverty thresholds or above.
ii Compared with persons with any college education.
iii Compared with persons under 65 with any private health insurance.
iv Source: Substance Abuse and Mental Health Services Administration, National Survey on Drug Use and Health, 2007.
v Source: National Vital Statistics System-Mortality, 2006.
vi Source: Medical Expenditure Panel Survey, 2006.
vii Source: National Health Interview Survey, 2007.

Key: HS=high school.

Key to Symbols Used in Quality of Health Care Tables:
= Group and comparison group receive about same quality of health care or have similar outcomes.
↑ Group receives better quality of health care than the comparison group or has better outcomes.
↓ Group receives poorer quality of health care than the comparison group or has worse outcomes.
Blank cell: Reliable estimate for group could not be made.


Proceed to Next Section

Current as of March 2010
Internet Citation: Chapter 2. Quality of Health Care (continued, 5): National Healthcare Disparities Report, 2009. March 2010. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/research/findings/nhqrdr/nhdr09/Chap2e.html