2012 National Healthcare Quality Report

2012 National Healthcare Quality Report

Chapter 2, Text Descriptions for Figures (continued)

Figure 2.34. Adults age 65 and over who reported having influenza vaccination in the past 12 months, by insurance and education, 2000-2010

Insurance 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010
Total 64.6 63.2 65.9 65.6 64.7 59.7 64.3 66.8 67.3 67 63.6
Medicare and Private 68.4 66.7 70.5 69.7 68.7 63.3 68.5 70.6 70.6 70.1 67.3
Medicare and Public 57.8 55.8 60.5 61.1 61 58.4 67.9 65.1 67.3 66.4 63.4
Medicare Only 57.7 57.9 58.4 57.8 58.6 53 54.7 60.6 61.3 62.3 58

 

Education 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010
Any College 70.3 67.9 71.5 70.1 69.7 64.8 70.1 71.5 69 68.9 68.1
High School Grad 65.7 63 67.1 68.2 64.7 59.6 64 65.4 67.7 67.3 62.6
>High School 57.6 58 57.8 57.4 57.9 53 57.3 61.3 63 62.9 56.5

Source: Centers for Disease Control and Prevention, National Center for Health Statistics, National Health Interview Survey, 2000-2010.
Denominator: Civilian noninstitutionalized population age 65 and over.
Note: Age adjusted to the 2000 U.S. standard population. Benchmark is derived from the Behavioral Risk Factor Surveillance System; go to Chapter 1, Introduction and Methods, for details.

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Figure 2.35. State variation: Adults age 65 and over who reported having influenza vaccination in the past 12 months, 2010

Quartile States
Lowest Quality Quartile Alaska, Oregon, California, Nevada, Idaho, Wyoming, Louisiana, Ohio, Alabama, Georgia, Florida
Second Quartile Montana, Arizona, North Dakota, Texas, Missouri, Illinois, Indiana, Michigan, Tennessee, Mississippi, West Virginia, Delaware, New Jersey
Third Quartile Washington, Utah, New Mexico, Kansas, Arkansas, Wisconsin, Kentucky, New York, Pennsylvania, Maryland, Virginia, North Carolina, South Carolina
Highest Quality Quartile Colorado, South Dakota, Nebraska, Oklahoma, Minnesota, Iowa, Maine, New Hampshire, Vermont, Massachusetts, Connecticut, Rhode Island

Key: Lowest Quality Quartile identifies States with the lowest rates of influenza vaccination; Highest Quality Quartile identifies States with the highest rates of influenza vaccination.
Source: Centers for Disease Control and Prevention, Behavioral Risk Factor Surveillance System, 2010.

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Figure 2.36. Hospital patients with pneumonia who received recommended hospital care, by age and gender, 2007-2010

Age Group 2007 2008 2009 2010
<65 87.7 89.6 92.3 94.6
65-74 86.2 89.4 92.7 94.1
75-84 87.2 90.4 93.4 94.6
85+ 86.5 89.9 93.1 94.4

 

Gender 2007 2008 2009 2010
Total 87.0 89.8 92.9 94.3
Male 87.0 90.0 92.9 94.3
Female 86.9 89.8 92.8 94.2

Source: Centers for Medicare & Medicaid Services, Medicare Quality Improvement Organization Program, 2007-2010.
Denominator: Patients hospitalized with a principal discharge diagnosis of pneumonia or a principal discharge diagnosis of either septicemia or respiratory failure and secondary diagnosis of pneumonia.
Note: Recommended care includes initial antibiotics within 6 hours of hospital arrival, antibiotics consistent with current recommendations, blood culture before antibiotics are administered, influenza vaccination status assessment or provision, and pneumococcal vaccination status assessment or provision.

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Figure 2.37. Patients with tuberculosis who completed a curative course of treatment within 1 year of initiation of treatment, by age and gender, 2000-2008

Age Group 2000 2001 2002 2003 2004 2005 2006 2007 2008
0-17 89.8 88.2 89.7 90.4 90.1 91.4 92 91.8 92.3
18-44 78.2 78.9 79.7 80.5 80.9 82.2 82.3 83.3 84
45-64 80.4 80.5 81 81.2 81.6 81.9 83.4 84.2 84.3
65+ 81.1 81.4 79.6 82.4 83.4 81.6 83 83.5 83.9

 

Gender 2000 2001 2002 2003 2004 2005 2006 2007 2008
Total 80.2 80.5 80.9 81.8 82.3 82.8 83.5 84.3 84.7
Male 80.1 79.8 80 81.3 80.8 82 82.2 83.5 84
Female 80.4 81.8 82.3 82.7 84.6 84.1 85.5 85.6 85.9

Source: Centers for Disease Control and Prevention, National Tuberculosis Surveillance System, 2000-2008.
Denominator: U.S. civilian noninstitutionalized population treated for tuberculosis.

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Figure 2.38. People with current asthma who reported taking preventive asthma medicine daily or almost daily, by age and insurance, 2003-2009

Age Group 2003 2004 2005 2006 2007 2008 2009
Total 29.6 29.7 31.2 30.9 28.3 25.9 25.1
0-17 28.4 32.8 30.6 31.2 29.7 24.2 23.4
18-44 21.4 20.5 23.1 23.7 19.9 16.7 16.5
45-64 38.7 35.6 40.7 33.8 32.9 32.4 30.6
65+ 42 41.8 41 47.6 43.6 46.3 45.9

 

Insurance 2003 2004 2005 2006 2007 2008 2009
Private 29.8 29.9 31.6 29.1 28.6 24.9 24.1
Public 29.5 27.2 29.1 30.2 26.2 23.1 22.8
Uninsured 16.7 15.5 13.5 17.4 13.4 14.9 9.6

Source: Agency for Healthcare Research and Quality, Medical Expenditure Panel Survey, 2003-2009.
Denominator: Civilian noninstitutionalized population with asthma.
Note:
Age adjusted to the 2000 U.S. standard population. People with current asthma report that they still have asthma or had an asthma attack in the last 12 months. Insurance groups presented are for patients under age 65.

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Figure 2.39. People with current asthma who received a written asthma management plan from their health provider, by age, gender, insurance, and residence location, 2009

Age Group / Gender / Insurance / Location Asthma management plan
Total 33.4
0-17 44.3
18-44 29.8
45-64 31.9
65+ 26.1
Male 32.5
Female 33.7
Any Private, <65 37.4
Public Only, <65 33.8
Uninsured, <65 25.8
Medicare & Private, 65+ 17.3
Medicare & Public, 65+ 35.2
Medicare Only, 65+ 39.2
Large Central MSA 37.3
Large Fringe MSA 36.0
Medium MSA 34.8
Small MSA 32.0
Micropolitan 27.2
Noncore 20.1

Key: MSA = metropolitan statistical area.
Source: Centers for Disease Control and Prevention, National Center for Health Statistics, National Health Interview Survey, 2009.
Denominator: Patients with current asthma.
Note: Estimates are age adjusted to the 2000 U.S. standard population. Rates by age are not age adjusted.

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Figure 2.40. Adult current smokers with a checkup in the last 12 months who received advice to quit smoking, by gender and insurance, 2002-2009

Gender 2002 2003 2004 2005 2006 2007 2008 2009
Total 63.1 65.3 63.1 63.4 62.7 65.1 64.5 67.6
Male 61.4 63.0 59.7 60.0 59.7 64.0 62.9 63.3
Female 64.5 67.2 65.7 66.2 65.1 66.1 65.8 71.3

 

Insurance 2002 2003 2004 2005 2006 2007 2008 2009
Any Private Insurance 62.3 65.7 64.1 61.9 60.7 65.9 62.8 70.5
Public Only 64.7 71.7 67.6 69.1 67.6 70.1 69.3 69.9
Uninsured 51.3 46.6 46.2 49.2 48.1 52.0 52.8 48.5

Source: Agency for Healthcare Research and Quality, Medical Expenditure Panel Survey, 2002-2008.
Denominator: Civilian noninstitutionalized adult current smokers who had a checkup in the last 12 months.

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Figure 2.41. Adults with obesity age 20 and over who reported being told by a doctor they were overweight, by age and gender, 2007-2010

Age Group / Gender 2007-2010
Total 35
20-44 32
45-64 38
65+ 35
Male 34
Female 36

Source: Centers for Disease Control and Prevention, National Center for Health Statistics, National Health and Nutrition Examination Survey.
Denominator: People age 20 and over with a body mass index of 30 or greater.
Note: Estimates are age adjusted to the 2000 U.S. standard population. Total, and gender are adjusted using three age groups: 20-44, 45-64, and 65 and over.

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Figure 2.42. Overweight children and teens ages 2-19 who were told by a doctor or health professional that they were overweight, by age and gender, 2007-2010

Age Group / Gender 2007-2010
Total 45
2-5 23
6-11 41
12-19 54
Male 41
Female 49

Source: Centers for Disease Control and Prevention, National Center for Health Statistics, National Health and Nutrition Examination Survey.
Denominator: U.S. civilian noninstitutionalized population ages 2-19 who were overweight
Note: Overweight children are identified using age- and sex-specific reference data from the 2000 Centers for Disease Control and Prevention body mass index (BMI) for age growth charts. Children with BMI values at or above the 95th percentile of the sex-specific BMI growth charts are categorized as overweight.

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Figure 2.43. Adults with obesity who ever received advice from a health provider to exercise more, by gender or activity limitation, 2002-2009

Gender / Limitation 2002 2003 2004 2005 2006 2007 2008 2009
Total 55.6 57.0 57.2 56.7 57.1 57.9 57.4 59.1
Male 52.1 52.9 52.4 52.4 52.8 53.7 53.8 54.7
Female 59.2 61.1 62.0 61.0 61.7 62.2 60.8 63.3

 

Limitation 2002 2003 2004 2005 2006 2007 2008 2009
Basic 65.9 70.3 71.7 67.6 70.2 71.2 65.1 68.2
Complex 67.3 67.4 68.4 66.7 68.4 71.4 67.9 67.8
Neither Basic nor Complex 53.8 54.7 54.9 54.5 54.5 56.3 55.5 57.9

Source: Agency for Healthcare Research and Quality, Medical Expenditure Panel Survey, 2002-2009.
Denominator: Civilian noninstitutionalized adults age 18 and over with obesity.
Note: For this measure, lower rates are better. Obesity is defined as a body mass index of 30 or higher. Basic activity limitations refer to problems with mobility, self-care, domestic life, and activities that depend on sensory functioning, and complex activity limitations refer to limitations experienced in work and in community, social, and civic life. Neither indicates people with neither basic nor complex activity limitations

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Figure 2.44. Adults with obesity who did not spend half an hour or more in moderate or vigorous physical activity at least three times a week, by gender and insurance, 2002-2009

Gender 2002 2003 2004 2005 2006 2007 2008 2009
Total 54.3 54.3 53.0 52.0 52.3 53.3 53.1 51.7
Male 50.2 49.0 47.4 46.8 48.0 48.5 47.7 46.9
Female 58.1 58.8 58.0 56.6 56.7 57.9 58.2 56.2

 

Insurance 2002 2003 2004 2005 2006 2007 2008 2009
Any Private 51.3 50.7 49.5 48.0 48.9 49.5 49.5 47.7
Public Only 60.9 63.0 61.5 59.1 58.4 60.1 58.8 60.7
Uninsured 52.1 55.1 51.4 50.8 50.5 52.5 50.5 47.0

Source: Agency for Healthcare Research and Quality, Medical Expenditure Panel Survey, 2002-2009.
Denominator: Civilian noninstitutionalized population age 18 and over.
Note: Obesity is defined as a body mass index of 30 or higher.

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Figure 2.45. Children ages 2-17 for whom a health provider gave advice within the past 2 years about exercise, by age and special health care needs, 2002-2009

Age Group 2002 2003 2004 2005 2006 2007 2008 2009
Total 30.0 29.3 31.0 31.9 34.6 36.2 33.5 34.7
2-5 25.0 24.1 27.4 31.1 31.0 34.4 30.3 32.1
6-17 31.6 31.0 32.1 32.2 35.8 36.8 34.6 35.5

 

Special Health Care Needs 2002 2003 2004 2005 2006 2007 2008 2009
CSHCN 39.6 36.7 39.1 41.1 41.3 43.7 42.8 44.2
Not CSHCN 27.5 27.3 28.9 29.5 32.8 34.2 31.2 32.1

Key: CSHCN = children with special health care needs. See Medical Expenditure Panel Survey documentation for the 2008 Full Year Consolidated Data File at http://www.meps.ahrq.gov/mepsweb/data_stats/download_data_files_detail.jsp?cboPufNumber=HC-121 for details.
Source: Agency for Healthcare Research and Quality, Medical Expenditure Panel Survey, 2002-2009.
Denominator: U.S. civilian noninstitutionalized population ages 2-17.
Note: Exercise advice includes the amount and kind of sports or physically active hobbies children should engage in.

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Figure 2.46. Adults with obesity who ever received advice from a health provider about eating fewer high-fat or high-cholesterol foods, by age and insurance, 2002-2009

Age Group 2002 2003 2004 2005 2006 2007 2008 2009
Total 47.7 48.3 47.4 48.1 48.5 50.0 49.2 51.3
18-44 35.9 37.3 35.4 36.7 36.3 39.1 39.2 41.3
45-64 59.9 60.3 59.4 58.6 60.2 60.1 60.0 61.1
65+ 63.1 61.6 63.8 65.4 66.0 66.4 61.4 65.3

 

Insurance 2002 2003 2004 2005 2006 2007 2008 2009
Any Private 47.1 48.0 47.4 47.6 47.1 49.3 49.0 50.8
Public Only 44.9 47.3 47.5 47.5 49.7 50.8 48.7 51.1
Uninsured 33.6 34.4 27.6 29.7 32.3 32.3 36.9 38.2

Source: Agency for Healthcare Research and Quality, Medical Expenditure Panel Survey, 2002-2009.
Denominator: Civilian noninstitutionalized population age 18 and over.
Note: Obesity is defined as a body mass index of 30 or higher.

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Figure 2.47. Children ages 2-17 for whom a health provider ever gave advice about healthy eating, by age and gender, 2002-2009

Age Group 2002 2003 2004 2005 2006 2007 2008 2009
Total 46.9 47.5 48.7 50.1 51.4 52.8 49.6 49.5
2-5 57.0 57.4 59.1 61.1 61.6 62.9 57.6 58.5
6-17 43.7 44.3 45.4 46.5 47.9 49.6 47.0 46.4

 

Gender 2002 2003 2004 2005 2006 2007 2008 2009
Male 44.9 45.0 47.0 48.6 50.5 52.3 50.1 50.0
Female 49.0 50.1 50.6 51.6 52.2 53.3 49.2 49.0

Source: Agency for Healthcare Research and Quality, Medical Expenditure Panel Survey, 2002-2009.
Denominator: U.S. civilian noninstitutionalized population ages 2-17.

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Figure 2.48. Adult home health care patients whose ability to walk or move around improved, by age, 2010

Age Group 2010
Total 54.4
18-64 55
65-74 62
75-84 55.7
85+ 45.6

Source: Centers for Medicare & Medicaid Services, Outcome and Assessment Information Set (OASIS), 2010.
Denominator: Adult nonmaternity patients completing an episode of skilled home health care and not already performing at the highest level at the start of the episode, according to the OASIS question on ambulation.
Note: Starting January 1, 2010, the patient assessment instrument for home health agencies was changed to OASIS-C and ambulation improvement is measured differently than with the previous version of the assessment instrument. Therefore, we are presenting only 2010 data.

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Figure 2.49. Long-stay nursing home residents whose need for help with daily activities increased, by age, 2000-2010

Age Group 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010
Total 16.0 16.1 16.1 16.1 16.2 16.0 16.5 15.9 16.2 15.8 15.4
0-64 9.8 9.9 9.9 10.1 10.7 10.7 11.4 11.1 11.9 11.7 12.0
65-74 14.4 14.5 14.5 14.8 15.1 15.0 15.7 15.5 15.6 15.2 15.1
75-84 16.7 16.9 16.9 17.0 17.0 17.0 17.4 16.9 17.1 16.7 16.3
85+ 17.2 17.3 17.4 17.4 17.4 17.2 17.6 16.9 17.1 16.7 16.0

Source: Centers for Medicare & Medicaid Services, Minimum Data Set, 2000-2010. Data are from the third quarter of each calendar year.
Denominator: All long-stay residents in Medicare- or Medicaid-certified nursing home facilities.

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Figure 2.50. FIM scores at admission and discharge and changes in total functional gain among patients with all diagnoses in inpatient rehabilitation facilities, 2004-2011

Gain Admission Score Discharge Score
2004 2005 2006 2007 2008 2009 2010 2011 2004 2005 2006 2007 2008 2009 2010 2011 2004 2005 2006 2007 2008 2009 2010 2011
25.7 26.6 27.1 27.7 28.2 28.9 29.6 30.3 71.4 69.4 67.5 66.2 65.4 64.3 63.8 63.5 97.1 96.0 94.6 93.9 93.6 93.2 93.4 93.8

Key: FIM = Functional Independence Measure.
Source: Centers for Medicare & Medicaid Services, Inpatient Rehabilitation Facility Patient Assessment Instrument, 2004-2011.
Denominator: All Medicare patients in an inpatient rehabilitation facility for initial rehabilitation and discharged to the community (home, board and care, transitional living, or assisted living).

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Figure 2.51. Changes in total functional gain among patients with all diagnoses in inpatient rehabilitation facilities, by age and gender, 2004-2011

Age Group 2004 2005 2006 2007 2008 2009 2010 2011
Total 25.7 26.6 27.1 27.7 28.2 28.9 29.6 30.3
<65 25.0 25.8 26.2 26.7 27.4 28.1 28.9 29.6
65-74 26.1 27.1 27.6 28.2 28.7 29.5 30.2 30.8
75-84 25.8 26.8 27.3 27.9 28.5 29.1 29.8 30.5
85+ 24.7 25.5 26.1 26.7 27.3 28.0 28.7 29.5

 

Gender 2004 2005 2006 2007 2008 2009 2010 2011
Male 25.3 26.2 26.8 27.2 27.9 28.5 29.2 29.9
Female 25.9 26.8 27.3 27.9 28.5 29.2 29.8 30.6

Source: Centers for Medicare & Medicaid Services, Inpatient Rehabilitation Facility Patient Assessment Instrument, 2004-2011.
Denominator: All Medicare patients in an inpatient rehabilitation facility for initial rehabilitation and discharged to the community (home, board and care, transitional living, and assisted living).

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Figure 2.52. Adult home health care patients who had less shortness of breath between the start and end of a home health care episode, by age, 2002-2010

Age Group 2002 2003 2004 2005 2006 2007 2008 2009 2010
Total 53.3 55.1 57.6 58.9 60.8 61.3 60.5 60.1 62.3
18-64 51.8 53.3 55.8 56.9 58.5 59 58.3 58 60.6
65-74 54.6 56.6 59.1 60.6 62.4 62.8 62.3 62.1 63.7
75-84 53.8 55.7 58.2 59.6 61.6 62.1 61.3 60.9 63
85+ 51.8 53.5 56 57.4 59.3 59.8 58.9 58.5 61

Source: Centers for Medicare & Medicaid Services, Outcome and Assessment Information Set (OASIS), 2002-2010.
Denominator: Adult nonmaternity patients completing an episode of skilled home health care.
Note: Starting January 1, 2010, the patient assessment instrument for home health agencies was changed to OASIS-C. Because dyspnea improvement is measured similarly in both the previous and current versions of the assessment instrument, we are presenting 2002 through 2010 trend data.

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Figure 2.53. Short-stay (top) and high-risk long-stay (bottom) nursing home residents with pressure sores, by gender, 2000-2010

Gender 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010
Total 22.6 22 21.6 21.7 21.2 20.7 20.1 19.5 18.9 17.8 17
Male 24.96 24.31 23.91 23.91 23.42 22.96 22.4 21.77 21.05 20 19.1
Female 21.41 20.94 20.49 20.54 20.05 19.61 18.99 18.32 17.78 16.7 15.9

 

Gender 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010
Total 13.9 13.8 13.7 13.9 13.5 13.1 12.5 12.0 11.70 10.9 10.4
Male 16.69 16.50 16.53 16.88 16.55 16.14 15.41 14.83 14.57 13.5 12.9
Female 12.95 12.92 12.74 12.80 12.39 12.00 11.47 10.94 10.61 9.9 9.4

Source: Centers for Medicare & Medicaid Services, Minimum Data Set, 2000-2010. Data for long-stay residents are from the third quarter of each calendar year. Data for short-stay residents are full calendar-year estimates.
Denominator: Short-stay and high-risk long-stay nursing home residents in Medicare- or Medicaid-certified nursing and long-term care facilities.
Note: For this measure, lower rates are better. On October 1, 2010, CMS required nursing homes to begin using the Minimum Data Set (MDS) 3.0. The figure uses the earlier MDS 2.0 instrument, which includes data from the first 9 months of 2010.

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Figure 2.54. Hospice patients age 18 and over who did NOT receive the right amount of help for feelings of anxiety or sadness, by age, 2008-2011

Age Group 2008 2009 2010 2011
Total 9.7 9.4 9.5 9.80
18-44 14.7 12.9 11.8 13.80
45-64 11.2 10.8 11.3 12.00
65+ 9.4 9.1 9.2 9.40

Source: National Hospice and Palliative Care Organization, Family Evaluation of Hospice Care, 2008-2011.
Denominator: Adult hospice patients.
Note: For this measure, lower rates are better.

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Figure 2.55. Hospice patients age 18 and over whose family caregivers wanted more information about what to expect while the patient was dying, by age, 2008-2011

Age Group 2008 2009 2010 2011
Total 15.3 15.0 14.9 15.3
18-44 18.1 19.2 19.1 19.3
45-64 18.3 18.5 17.8 18.6
65+ 14.7 14.4 14.4 14.9

Source: National Hospice and Palliative Care Organization, Family Evaluation of Hospice Care, 2008-2011.
Denominator: Adult hospice patients.
Note: For this measure, lower rates are better.

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Figure 2.56. Hospice patients age 18 and over who did NOT receive care consistent with their stated end-of-life wishes, by age, 2008-2011

Age Group 2008 2009 2010 2011
Total 5.8 5.4 5.6 5.4
18-44 10.7 6.6 5.7 10.0
45-64 6.9 6.7 6.6 6.8
65+ 5.6 5.3 5.5 5.4

Source: National Hospice and Palliative Care Organization, Family Evaluation of Hospice Care, 2008-2011.
Denominator: Adult hospice patients.
Note: For this measure, lower rates are better.

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Page last reviewed May 2013
Internet Citation: 2012 National Healthcare Quality Report. May 2013. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/research/findings/nhqrdr/nhqr12/chap2-text3.html