Priority Populations: Racial and Ethnic Minorities 2008 National Healthcare Quality and Disparities ReportsThe National Healthcare Quality Report (NHQR) is a comprehensive national overview of quality of health care in the United States. It is organized around four dimensions of quality of care: effectiveness, patient safety, timeliness, and patient centeredness. Priority Populations: Racial and Ethnic MinoritiesNative Hawaiians and Other Pacific Islanders Adults who did not receive a cholesterol check in the last 5 years Adults age 65 and over who did not receive a flu shot in the last 12 months Adults age 65 and over who never received a pneumococcal vaccine Adults under age 65 without health insurance Adults who reported they did not have a personal doctor Adults who needed to see a doctor but could not because of cost in the last 12 months Adults age 50 and over who did not receive a blood stool test in the last 2 years or did not ever have a sigmoidoscopy/colonoscopy American Indians/Alaska Natives Hospital admissions for uncontrolled diabetes per 100,000 population age 18 years and over in Indian Health Service tribal direct and contract hospitals and community hospitals Perforated appendixes per 1,000 admissions with appendicitis, age 18 years and over with appendicitis in IHS tribal direct and contract hospitals and community hospitals Hospitalizations for urinary tract infection per 100,000 population 18 years and over in IHS tribal direct and contract hospitals and community hospitals Recent Immigrants/Limited English Proficiency Completion of therapy for tuberculosis within 12 months of being diagnosed among people born outside the United States Composite measure: Adults who had a doctor's office or clinic visit in the last 12 months whose health providers listened carefully, explained things clearly, respected what they had to say, and spent enough time with them Adults under age 65 who were uninsured all year Adults with limited English proficiency, by whether they had a usual source of care with or without language assistanceNative Hawaiians and Other Pacific IslandersMeasure TitleAdults who did not receive a cholesterol check in the last 5 years.Measure SourceHealthy People 2010.Table16_1_1.1 Adults who did not receive a cholesterol check in the last 5 years, United States, 2005Data SourceCenters for Disease Control and Prevention (CDC), National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Behavioral Risk Factor Surveillance System (BRFSS).DenominatorU.S. residents age 18 and over.NumeratorSubset of the denominator who reported they did not receive a cholesterol check.CommentsNative Hawaiian and Other Pacific Islander (NHOPI) includes people of mixed race who identified NHOPI to be the race that best represents their identity.Top of PageNative Hawaiians and Other Pacific IslandersMeasure TitleAdults age 65 and over who did not receive a flu shot in the last 12 months.Measure SourceHealthy People 2010.Table16_1_2.1 Adults age 65 and over who did not receive a flu shot in the last 12 months, United States, 2006Data SourceCenters for Disease Control and Prevention (CDC), National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Behavioral Risk Factor Surveillance System (BRFSS).DenominatorU.S. residents age 18 and over.NumeratorSubset of the denominator age 65 and over who reported they did not receive a flu shot.CommentsNative Hawaiian and Other Pacific Islander (NHOPI) includes people of mixed race who identified NHOPI to be the race that best represents their identity.Top of PageNative Hawaiians and Other Pacific IslandersMeasure TitleAdults age 65 and over who never received a pneumococcal vaccine.Measure SourceHealthy People 2010.Table16_1_3.1 Adults age 65 and over who did not ever receive a pneumococcal vaccine, United States, 2006Data SourceCenters for Disease Control and Prevention (CDC), National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Behavioral Risk Factor Surveillance System (BRFSS).DenominatorU.S. residents age 18 and over.NumeratorSubset of the denominator age 65 and over who reported they did not receive a pneumococcal vaccine.CommentsNative Hawaiian and Other Pacific Islander (NHOPI0 includes people of mixed race who identified NHOPI to be the race that best represents their identity.Top of PageNative Hawaiians and Other Pacific IslandersMeasure TitleAdults under age 65 without health insurance.Measure SourceAgency for Healthcare Research and Quality (AHRQ), Center for Financing, Access, and Cost Trends (CFACT), Medical Expenditure Panel Survey (MEPS).Table16_1_4.1 Adults without any health insurance in the last 12 months, United States, 2006Data SourceCenters for Disease Control and Prevention (CDC), National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Behavioral Risk Factor Surveillance System (BRFSS).DenominatorU.S. residents ages 18-64.NumeratorSubset of the denominator who reported they did not have any health insurance.CommentsNative Hawaiian and Other Pacific Islander (NHOPI) includes people of mixed race who identified NHOPI to be the race that best represents their identity.Top of PageNative Hawaiians and Other Pacific IslandersMeasure TitleAdults who reported they did not have a personal doctor.Measure SourceAgency for Healthcare Research and Quality (AHRQ), Center for Financing, Access, and Cost Trends (CFACT), Medical Expenditure Panel Survey (MEPS).Table16_1_5.1 Adults who reported they did not have a personal doctor, United States, 2006Data SourceCenters for Disease Control and Prevention (CDC), National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Behavioral Risk Factor Surveillance System (BRFSS).DenominatorU.S. residents age 18 and over.NumeratorSubset of the denominator who reported they did not have a personal doctor.CommentsNative Hawaiian and Other Pacific Islander (NHOPI) includes people of mixed race who identified NHOPI to be the race that best represents their identity.Top of PageNative Hawaiians and Other Pacific IslandersMeasure TitleAdults who needed to see a doctor but could not because of cost in the last 12 months.Measure SourceAgency for Healthcare Research and Quality (AHRQ), Center for Financing, Access, and Cost Trends (CFACT), Medical Expenditure Panel Survey (MEPS).Table16_1_6.1 People who needed to see a doctor but could not because of cost in the last 12 months, United States, 2006Data SourceCenters for Disease Control and Prevention (CDC), National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Behavioral Risk Factor Surveillance System (BRFSS).DenominatorU.S. residents.NumeratorSubset of the denominator who reported they could not see a doctor because of cost.CommentsNative Hawaiian and Other Pacific Islander (NHOPI) includes people of mixed race who identified NHOPI to be the race that best represents their identity.Top of PageNative Hawaiians and Other Pacific IslandersMeasure TitleAdults age 50 and over who did not receive a blood stool test in the last 2 years or did not ever have a sigmoidoscopy/colonoscopy.Measure SourceHealthy People 2010.Table16_1_7.1 Adults age 50 and over who did not receive a blood stool test in the last 2 years or had not ever had a sigmoidoscopy/colonoscopy, United States, 2006Data SourceCenters for Disease Control and Prevention (CDC), National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Behavioral Risk Factor Surveillance System (BRFSS).DenominatorU.S. residents age 50 and over.NumeratorSubset of the denominator age 50 and over who reported they did not receive a blood stool test or had not ever had a sigmoidoscopy/colonoscopy.CommentsNative Hawaiian and Other Pacific Islander (NHOPI) includes people of mixed race who identified NHOPI to be the race that best represents their identity.Top of PageAmerican Indians/Alaska NativesMeasure TitleHospital admissions for uncontrolled diabetes per 100,000 population age 18 years and over in Indian Health Service tribal direct and contract hospitals and community hospitals.Measure SourceAgency for Healthcare Research and Quality (AHRQ), Prevention Quality Indicators (PQIs).Table16_2_1.1 Hospital admissions for uncontrolled diabetes per 100,000 population age 18 and over in Indian Health Service tribal direct and contract hospitals and community hospitals, 2005Data SourceIndian Health Service (IHS), Office of Information Technology/National Patient Information Reporting System (OIT/NPIRS), National Data Warehouse, Workload and Population Data Mart.DenominatorIHS service population, age 18 and over, 2006.NumeratorAdult nonmaternal, nonneonatal admissions, age 18 and over, with a principal diagnosis of uncontrolled diabetes, without mention of short-term (ketoacidosis, hyperosmolarity, coma) or long-term complications (renal, eye, neurologic, circulatory, other unspecified) and excluding transfers from other institutions.CommentsBecause the California and Portland Areas have no IHS or tribal inpatient facilities, any hospitalizations attributed to either one of these regions were not included; the denominator was correspondingly reduced. Rates were computed using estimates of the American Indian/Alaska Native population as of July 1, 2006, based on the 2000 census.Data for the total were age adjusted using the 2000 standard population provided by NCHS: http://www.cdc.gov/nchs/data/statnt/statnt20.pdf (Plugin Software Help).The numerator includes hospitalizations in IHS hospitals and contract hospitals with admission dates from January 1, 2006, to December 31, 2006, inclusive.The International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes used to identify discharges for uncontrolled diabetes are the same as AHRQ Prevention Quality Indicator 2, but the format of NPIRS did not allow for exclusion of transfers.Top of PageAmerican Indians/Alaska NativesMeasure TitlePerforated appendixes per 1,000 admissions with appendicitis, age 18 years and over with appendicitis in IHS tribal direct and contract hospitals and community hospitals.Measure SourceAgency for Healthcare Research and Quality (AHRQ), Prevention Quality Indicators (PQIs).Tables16_2_2.1 Perforated appendixes per 1,000 admissions with appendicitis, age 18 and over, in Indian Health Service tribal direct and contract hospitals and community hospitals, 200516_2_2.2 Admissions with perforated appendix per 1,000 admissions, age 18 and over, with appendicitis (excluding obstetric admissions and transfers from other institutions), United States, 2005, by:Race/ethnicity.Data SourceAHRQ, Center for Delivery, Organization, and Markets (CDOM), Healthcare Cost and Utilization Project (HCUP), State Inpatient Databases (SID), disparities analysis file.DenominatorNumber of admissions with a primary or secondary diagnosis of appendicitis, excluding maternal and neonatal admissions and transfers from other institutions, age 18 and over, IHS service population, 2006.NumeratorSubset of the denominator with principal or secondary diagnosis of perforation or abscess of the appendix, IHS service population, 2006.CommentsBecause the California and Portland Areas have no IHS or tribal inpatient facilities, any hospitalizations attributed to either one of these regions were not included; the denominator was correspondingly reduced. Rates were computed using estimates of the American Indian/Alaska Native population as of July 1, 2006, based on the 2000 census.Data for the total were age adjusted using the 2000 standard population provided by NCHS: http://www.cdc.gov/nchs/data/statnt/statnt20.pdf (Plugin Software Help).The numerator and denominator include hospitalizations in IHS hospitals and contract hospitals with admission dates from January 1, 2006, to December 31, 2006, inclusive.The SID disparities analysis file, created specifically for this report to provide national estimates on disparities, consists of weighted records from a sample of hospitals from the following 23 States that participate in HCUP and have high-quality race/ethnicity data: AZ, AR, CA, CO, CT, FL, GA, HI, KS, MD, MA, MI, MO, NH, NJ, NY, OK, RI, SC, TN, TX, VT, and WI.Top of PageAmerican Indians/Alaska NativesMeasure TitleHospitalizations for urinary tract infection per 100,000 population 18 years and over in IHS tribal direct and contract hospitals and community hospitals.Measure SourceAgency for Healthcare Research and Quality (AHRQ), Prevention Quality Indicators (PQIs).Tables16_2_3.1 Hospitalizations for urinary tract infection per 100,000 population 18 years and over in Indian Health Service tribal direct and contract hospitals and community hospitals, 200516_2_3.2 Admissions for urinary tract infections (excluding kidney or urinary tract disorders, patients in an immunocompromised state, transfers from other institutions, and obstetric admissions) per 100,000 population, age 18 and over, United States, 2005, by:Race/ethnicity.Data SourceAHRQ, Center for Delivery, Organization, and Markets (CDOM), Healthcare Cost and Utilization Project (HCUP), State Inpatient Databases (SID), disparities analysis file.DenominatorIHS service population, age 18 and over, 2006.NumeratorAdult nonmaternal, nonneonatal admissions, excluding cases with a diagnosis of a kidney/urinary tract disorder or immunocompromised state and transfers from other institutions, with a principal diagnosis of urinary tract infection, 2006.CommentsBecause the California and Portland Areas have no IHS or tribal inpatient facilities, any hospitalizations attributed to either one of these regions were not included; the denominator was correspondingly reduced. Rates were computed using estimates of the American Indian/Alaska Native population as of July 1, 2006, based on the 2000 census.Data for the total were age adjusted using a standard population provided by NCHS: http://www.cdc.gov/nchs/data/statnt/statnt20.pdf (Plugin Software Help).The numerator includes hospitalizations in IHS hospitals and contract hospitals with admission dates from January 1, 2006, to December 31, 2006, inclusive.The SID disparities analysis file, created specifically for this report to provide national estimates on disparities, consists of weighted records from a sample of hospitals from the following 23 States that participate in HCUP and have high-quality race/ethnicity data: AZ, AR, CA, CO, CT, FL, GA, HI, KS, MD, MA, MI, MO, NH, NJ, NY, OK, RI, SC, TN, TX, VT, and WI.Top of PageRecent Immigrants/Limited English ProficiencyMeasure TitleCompletion of therapy for tuberculosis within 12 months of being diagnosed among people born outside the United States.Measure SourceAmerican Thoracic Society.Centers for Disease Control and Prevention (CDC), Division of Tuberculosis Elimination.Tables8_2_9.2 Patients with tuberculosis who completed a curative course of treatment within 1 year of initiation of treatment, United States, 2004, by:Race.Ethnicity.Race (foreign born only).Ethnicity (foreign born only).Data SourceCDC, National Tuberculosis Surveillance System (NTBSS).DenominatorU.S. resident population with verified tuberculosis (TB), eligible to complete therapy within 1 year.NumeratorTuberculosis cases completing therapy within 1 year.CommentsSee American Thoracic Society/Centers for Disease Control and Prevention/Infectious Diseases Society of America. Treatment of tuberculosis. Am J Respir Crit Care Med 2003;167:603-62. This article has more information on current tuberculosis treatment guidelines.For a discussion of completion of TB therapy, see Appendix A of Reported tuberculosis in the United States, 2003, available at http://www.cdc.gov/tb/statistics/reports/surv2003/default.htm.This measure and its tables are also presented in other relevant sections of the National Healthcare Disparities Report.Top of PageRecent Immigrants/Limited English ProficiencyMeasure TitleComposite measure: Adults who had a doctor's office or clinic visit in the last 12 months whose health providers listened carefully, explained things clearly, respected what they had to say, and spent enough time with them.Measure SourceAgency for Healthcare Research and Quality (AHRQ), Consumer Assessment of Healthcare Providers and Systems (CAHPS®).AHRQ, Center for Financing, Access, and Cost Trends (CFACT), Medical Expenditure Panel Survey (MEPS).Tables12_1_1.3 Adults who had a doctor's office or clinic visit in the last 12 months whose health providers always listened carefully, explained things clearly, respected what they had to say, and spent enough time with them, United States, 2005, by:Race.Ethnicity.Family income.Education.12_1_1.4 Adults who had a doctor's office or clinic visit in the last 12 months whose health providers usually listened carefully, explained things clearly, respected what they had to say, and spent enough time with them, United States, 2005, by:Race.Ethnicity.Family income.Education.12_1_1.5 Adults who had a doctor's office or clinic visit in the last 12 months whose health providers sometimes or never listened carefully, explained things clearly, respected what they had to say, and spent enough time with them, United States, 2005, by:Race.Ethnicity.Family income.Education.Data SourceAHRQ, CFACT, MEPS.DenominatorU.S. civilian noninstitutionalized adults age 18 and over who had at least one visit to a doctor's office or clinic in the previous 12 months (not including visits to an emergency room).NumeratorU.S. civilian noninstitutionalized adults age 18 and over who had at least one visit to a doctor's office or clinic in the previous 12 months (not including visits to an emergency room) who subsequently reported their provider's level of communication on some or all of the four components of the composite measure as always, usually, sometimes, or never; depending on the table.CommentsThis measure and its tables are also presented in other relevant sections of the National Healthcare Disparities Report.Percentage estimates are weighted; percentage weights are adjusted for nonresponse based on how many questions had a valid response.Tables report data from the MEPS Self-Administered Questionnaire (SAQ). See the MEPS entry in the Data Sources appendix for more information on the SAQ.Top of PageRecent Immigrants/Limited English ProficiencyMeasure TitleAdults under age 65 who were uninsured all year.Measure SourceAgency for Healthcare Research and Quality (AHRQ), Center for Financing, Access, and Cost Trends (CFACT), Medical Expenditure Panel Survey (MEPS).Tables14_1_5.1 People under age 65 who were uninsured all year, United States, 2005, by:Race.Ethnicity.Family income.Education.Data SourceAHRQ, CFACT, MEPS.DenominatorU.S. civilian noninstitutionalized population under age 65.NumeratorU.S. civilian noninstitutionalized population under age 65 who reported no private or public health insurance coverage at any time during the year.CommentsThis measure and its tables are also presented in other relevant sections of the National Healthcare Disparities Report.Top of PageRecent Immigrants/Limited English ProficiencyMeasure TitleAdults with limited English proficiency, by whether they had a usual source of care with or without language assistance.Measure SourceAgency for Healthcare Research and Quality (AHRQ), Center for Financing, Access, and Cost Trends (CFACT), Medical Expenditure Panel Survey (MEPS).Table16_3_4.1 Adults with limited English proficiency, by whether they had a usual source of care (USC) with or without language assistance, United States, 2005Data SourceAHRQ, CFACT, MEPS.DenominatorU.S. civilian noninstitutionalized population with limited English proficiency.NumeratorSubset of the denominator with and without a usual source of care who offers language assistance. AHRQ Home | Questions? | Contact AHRQ | Site Map | Accessibility | Privacy Policy | Freedom of Information Act | Disclaimers U.S. Department of Health & Human Services | The White House | USA.gov: The U.S. Government's Official Web PortalAgency for Healthcare Research and Quality 540 Gaither Road Rockville, MD 20850 Telephone: (301) 427-1364 Current as of September 2009 Internet Citation: Priority Populations: Racial and Ethnic Minorities: 2008 National Healthcare Quality and Disparities Reports. September 2009. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/research/findings/nhqrdr/nhqrdr08/measurespec/racial_and_ethnic_minorities.html