Priority Populations: Children

2009 National Healthcare Quality and Disparities Reports

The 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.


Children
Composite measure: Children ages 19-35 months who received all recommended vaccines
Children ages 2-17 for whom a health provider ever gave advice about healthy eating
Children ages 2-17 who had a dental visit in the calendar year
Accidental puncture or laceration during procedure per 1,000 discharges, children under 18
Perforated appendixes per 1,000 admissions with appendicitis, ages 1-17
People under age 65 with health insurance
 


Children

Measure Title

Composite measure: Children ages 19-35 months who received all recommended vaccines.

Measure Source

Healthy People 2010.

National Tables

6_3_1.2 Children ages 19-35 months who received all recommended vaccines (4:3:1:3:3), United States, 2007, by:

  • Race.
  • Ethnicity.
  • Family income.

National Data Source

Centers for Disease Control and Prevention (CDC), National Center for Health Statistics and National Center for Immunization and Respiratory Diseases (NCHS-NCIRD), National Immunization Survey (NIS).

National Denominator

U.S. civilian noninstitutionalized population: children ages 19-35 months.

National Numerator

Number of children ages 19-35 months receiving at least 4 doses of diphtheria-tetanus-acellular pertussis (DTaP), at least 3 doses of polio, at least 1 dose of measles-mumps-rubella (MMR), at least 3 doses of Haemophilus influenzae B (Hib), and at least 3 doses of hepatitis B antigens.

Comments

Race categories changed in 2001. Data for 2001 and later years may not be comparable with data from previous years.

This measure is referred to as measure 14-24a in Healthy People 2010 documentation.

The vaccines included in this measure are based on the corresponding Healthy People 2010 objective. These include at least 4 doses of DTaP vaccine; at least 3 doses of polio vaccine; at least 1 dose of MMR vaccine; at least 3 doses of Hib vaccine; and at least 3 doses of hepatitis B vaccine. Between 1998 and 2005, the following vaccines were added to the list of recommended vaccines for children up to 35 months of age but were not added to this composite measure: pneumococcal conjugate vaccine (PCV) added in 2001 and influenza vaccine added in 2004. Varicella vaccine and vaccines added after 1998 to the recommended schedule for children up to 35 months of age also are not included in this composite measure.

This objective is one of the measures used to track the Immunization Leading Health Indicator.

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Children

Measure Title

Children ages 2-17 for whom a health provider ever gave advice about healthy eating.

Measure Source

Agency for Healthcare Research and Quality (AHRQ), Center for Financing, Access, and Cost Trends (CFACT), Medical Expenditure Panel Survey (MEPS).

Tables

6_4_6.3 Children ages 2-17 for whom a health provider ever gave advice about eating healthy, United States, 2006, by:

  • Race.
  • Ethnicity.
  • Family income.

Data Source

AHRQ, CFACT, MEPS.

Denominator

Children ages 2-17 for the “Ever given advice” estimates, excluding nonrespondents to the question, “Has a doctor or other health provider ever given advice about eating healthy?” “Don't know” responses to the question of when the advice was given were further excluded for “Within the past year” and “Within the past 2 years” estimates.

Numerator

Children ages 2-17 for whom a doctor or other health provider had ever given advice about eating healthy for the “Ever given advice” estimates. Children who were given the advice within the past year for “Within the past year” estimates. Children who were given the advice within the past year or 2 years for “Within the past 2 years” estimates.

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Children

Measure Title

Children ages 2-17 who had a dental visit in the calendar year.

Measure Source

Healthy People 2010.

Tables

6_4_2.2 2 Children ages 2-17 who had a dental visit in the calendar year, United States, 2006, by:

  • Race.
  • Ethnicity.
  • Family income.

Data Source

Agency for Healthcare Research and Quality (AHRQ), Center for Financing, Access, and Cost Trends (CFACT), Medical Expenditure Panel Survey (MEPS).

Denominator

U.S. population, children ages 2-17.

Numerator

Number of children ages 2-17 who had a dental visit in the survey year.

Comments

The age used to subset child population for the “children with special health care needs (CSHCN)” category is the age at the interview rounds when the questions about whether the child needs special health care were asked. For other categories, it is the age at the end of the year.

This measure is referred to as measure 21-10 in Healthy People 2010 documentation.

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Children

Measure Title

Accidental puncture or laceration during procedure per 1,000 discharges, children under 18.

Measure Source

Agency for Healthcare Research and Quality (AHRQ), Patient Quality Indicators (PQIs).

Table

11_1_4.1 Accidental puncture or laceration during procedure per 1,000 discharges (excluding obstetric admissions, normal newborns, and neonates with a birth weight less than 500 grams), under age 18, United States, 2006, by:

  • Race/ethnicity.

Data Source

AHRQ, Center for Delivery, Organization, and Markets (CDOM), Healthcare Cost and Utilization Project (HCUP), State Inpatient Databases (SID), disparities analysis file.

Denominator

Hospital medical and surgical discharges under age 18, excluding obstetric admissions.

Numerator

Subset of the denominator with secondary diagnosis denoting accidental cut, puncture, perforation, or laceration during a procedure (International Classification of Diseases, Ninth Revision, Clinical Modification [ICD-9-CM] codes E870.0-E870.9, 998.2).

Comments

Also excludes admissions specifically for such problems, such as cases from earlier admissions or from other hospitals.

Rates are adjusted by age, gender, Diagnosis Related Group (DRG) and Major Diagnostic Category (MDC) groups, and comorbidities.

Table for the pediatric measure was created using version 3.1 of the AHRQ PDI software. This measure is referred to as PDI 1 in the software documentation. More information about the AHRQ Quality Indicators is available at http://www.qualityindicators.ahrq.gov.

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 25 States that participate in HCUP and have high-quality race/ethnicity data: AR, AZ, CA, CO, CT, FL, GA, HI, KS, MA, MD, MI, MO, NH, NJ, NY, OK, RI, SC, TN, TX, UT, VA, VT, and WI.

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Children

Measure Title

Perforated appendixes per 1,000 admissions with appendicitis, ages 1-17.

Measure Source

Agency for Healthcare Research and Quality (AHRQ), Prevention Quality Indicators (PQIs).

Table

21_1_5.1 Admissions with perforated appendix per 1,000 admissions with appendicitis (excluding transfers from other institutions, obstetric admissions, normal newborns, and neonates), ages 1-17, United States, 2006, by:

  • Race/ethnicity.

Data Source

AHRQ, Center for Delivery, Organization, and Markets (CDOM), Healthcare Cost and Utilization Project (HCUP), State Inpatient Databases (SID), disparities analysis file.

Denominator

Nonmaternal discharges ages 1-17 with principal or secondary diagnosis of appendicitis, excluding transfers from other institutions.

Numerator

Subset of the denominator with principal or secondary diagnosis code for perforation or abscess of appendix.

Comments

Rates are adjusted by age and gender using the total U.S. population for 2000 as the standard population.

Table for the pediatric measure was created using version 3.1 of the AHRQ PDI software. This measure is referred to as PDI 17 in the software documentation. More information about the AHRQ Quality Indicators is available at http://www.qualityindicators.ahrq.gov.

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 25 States that participate in HCUP and have high-quality race/ethnicity data: AR, AZ, CA, CO, CT, FL, GA, HI, KS, MA, MD, MI, MO, NH, NJ, NY, OK, RI, SC, TN, TX, UT, VA, VT, and WI.

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Children

Measure Title

People under age 65 with health insurance.

Measure Source

Healthy People 2010.

Tables

16_1_1.1 People under age 65 with health insurance, United States, 2007, by:

  • Race.
  • Ethnicity.
  • Family income.

Data Source

Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS), National Health Interview Survey (NHIS).

Denominator

U.S. civilian noninstitutionalized population under age 65.

Numerator

People under age 65 who reported coverage by any type of public or private health insurance.

Comments

Data are age adjusted to the 2000 standard population. Age-adjusted rates are weighted sums of age-specific rates. For a discussion of age adjustment, see Part A, Section 5 of Tracking Healthy People 2010.

This measure is referred to as measure 1-1 in Healthy People 2010 documentation.

 

Current as of March 2010
Internet Citation: Priority Populations: Children: 2009 National Healthcare Quality and Disparities Reports. March 2010. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/research/findings/nhqrdr/nhqrdr09/measurespec/children.html