Priority Populations: Racial and Ethnic Minorities

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.


Asians
Adults age 50 and over who reported they had a sigmoidoscopy, a colonoscopy, or a fecal occult blood test within the past 5 years
Adults age 65 and over who received influenza vaccine within the past year.
People under age 65 who were uninsured all year.
Adults age 18 and over who had difficulty understanding their doctor during last visit.
Adults age 18 and over who report language barrier as a reason for having a difficult time understanding their doctor during their last visit within the past 2 years.

Native Hawaiians and Other Pacific Islanders
Adults who did not receive a cholesterol check in the last 5 years
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.
Adults who needed to see a doctor but could not because of cost in the last 12 months.

American Indians and Alaska Natives
Hospital admissions for uncontrolled diabetes per 100,000 population age 18 and over.
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.

Hispanics or Latinos
Adults age 50 and over who reported they had a sigmoidoscopy, a colonoscopy, or a fecal occult blood test within the past 5 years.
Composite measure: Adults age 40 and over with diagnosed diabetes who received all three recommended services for diabetes in the calendar year (hemoglobin A1c measurement, dilated eye examination, and foot examination).
People under age 65 who were uninsured all year.
Adults age 18 and over who had difficulty understanding their doctor during their last visit.
Adults age 18 and over who report language barrier as a reason for having a difficult time understanding their doctor during their last visit within the past 2 years.

Recent Immigrants and Limited-English-Proficient Populations
Patients with tuberculosis who completed a curative course of treatment within 1 year of initiation of treatment.
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.
People under age 65 who were uninsured all year.
Composite measure: Adults age 40 and over with diagnosed diabetes who received all three recommended services for diabetes in the calendar year (hemoglobin A1c measurement, dilated eye examination, and foot examination).
Adults with limited English proficiency, by whether they had a usual source of care with or without language assistance.


Asians

Measure Title

Adults age 50 and over who reported they had a sigmoidoscopy, a colonoscopy, or a fecal occult blood test within the past 5 years.

Measure Source

Healthy People 2010.

Table

18_2_1.1 Adults age 50 and over who reported they had a sigmoidoscopy, a colonoscopy, or a fecal occult blood test within the past 5 years, California, 2007, by:

  • Race
  • Ethnicity
  • Family income
  • Ethnicity

Data Source

University of California, Los Angeles (UCLA), California Health Interview Survey (CHIS).

Denominator

U.S. civilian noninstitutionalized population age 50 and over in California.

Numerator

Subset of the denominator who reported receiving a colonoscopy, sigmoidoscopy, proctoscopy, or fecal occult blood test within the past 5 years.

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Asians

Measure Title

Adults age 65 and over who received influenza vaccine within the past year.

Measure Source

Healthy People 2010.

Table

18_2_2.1 Adults age 65 and over who received influenza vaccine within the past year, California, 2007, by:

  • Race
  • Ethnicity
  • Family income
  • Ethnicity

Data Source

University of California, Los Angeles (UCLA), California Health Interview Survey (CHIS).

Denominator

U.S. civilian noninstitutionalized population age 65 and over in California.

Numerator

Subset of the denominator who report receiving an influenza vaccination in the past year.

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Asians

Measure Title

People under age 65 who were uninsured all year.

Measure Source

University of California, Los Angeles (UCLA), California Health Interview Survey (CHIS).

Table

18_2_3.1 People under age 65 who were uninsured all year, California, 2007, by:

  • Race
  • Ethnicity
  • Family income
  • Ethnicity

Data Source

UCLA, CHIS.

Denominator

U.S. civilian noninstitutionalized population under age 65 in California.

Numerator

Subset of the denominator who reported no private or public health insurance coverage at any time during the year.

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Asians

Measure Title

Adults age 18 and over who had difficulty understanding their doctor during their last visit.

Measure Source

University of California, Los Angeles (UCLA), California Health Interview Survey (CHIS).

Table

18_2_4.1 Adults age 18 and over who had difficulty understanding their doctor during their last visit, California, 2007, by:

  • Race
  • Ethnicity
  • Family income
  • Ethnicity

Data Source

UCLA, CHIS.

Denominator

U.S. civilian noninstitutionalized population age 18 and over in California.

Numerator

Subset of the denominator who had difficulty understanding their doctor during their last visit.

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Asians

Measure Title

Adults age 18 and over who report language barrier as a reason for having a difficult time understanding their doctor during their last visit within the past 2 years.

Measure Source

University of California, Los Angeles (UCLA), California Health Interview Survey (CHIS).

Table

18_2_5.1 Adults age 18 and over who report language barrier as a reason for having a difficult time understanding their doctor during their last visit within the past 2 years, California, 2007, by:

  • Race
  • Ethnicity
  • Family income
  • Ethnicity

Data Source

UCLA, CHIS.

Denominator

U.S. civilian noninstitutionalized population age 18 and over in California

Numerator

Subset of the denominator who reported language barrier as a reason for having a difficult time understanding their doctor during their last visit within the past 2 years.

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Native Hawaiians and Other Pacific Islanders

Measure Title

Adults who did not receive a cholesterol check in the last 5 years.

Measure Source

Healthy People 2010.

Table

18_3_1.1 Adults who did not receive a cholesterol check in the past 5 years, United States, 2005

Data Source

Centers for Disease Control and Prevention (CDC), National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Behavioral Risk Factor Surveillance System (BRFSS).

Denominator

U.S. residents age 18 and over.

Numerator

Subset of denominator who reported they did not receive a cholesterol check.

Comments

NHOPI includes people of mixed race who identified NHOPI to be the race that best represents their identity.

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Native Hawaiians and Other Pacific Islanders

Measure Title

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.

Measure Source

Healthy People 2010.

Table

18_3_2.1 Adults age 50 and over who did not receive a blood stool in the past 2 years or did not ever have a sigmoidoscopy/colonoscopy, United States, 2008

Data Source

Centers for Disease Control and Prevention (CDC), National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Behavioral Risk Factor Surveillance System (BRFSS).

Denominator

U.S. residents age 50 and over.

Numerator

Subset of denominator age 50 and over who reported they did not receive a blood stool test or had not ever had a sigmoidoscopy/colonoscopy.

Comments

NHOPI includes people of mixed race who identified NHOPI to be the race that best represents their identity.

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Native Hawaiians and Other Pacific Islanders

Measure Title

Adults who needed to see a doctor but could not because of cost in the last 12 months.

Measure Source

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

Table

18_3_4.1 Adults who needed to see a doctor but could not because of cost in the past 12 months, United States, 2008

Data Source

Centers for Disease Control and Prevention (CDC), National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Behavioral Risk Factor Surveillance System (BRFSS).

Denominator

U.S. residents.

Numerator

Subset of denominator who reported they could not see a doctor because of cost.

Comments

NHOPI includes people of mixed race who identified NHOPI to be the race that best represents their identity.

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American Indians and Alaska Natives

Measure Title

Hospital admissions for uncontrolled diabetes per 100,000 population age 18 and over.

Measure Source

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

National Table

2_3_1.3 Hospital admissions for uncontrolled diabetes per 100,000 population age 18 and over in Indian Health Service and tribal direct and contract hospitals and community hospitals, 2007

National Data Source

Indian Health Service (IHS), Office of Information Technology/National Patient Information Reporting System (OIT/NPIRS), National Data Warehouse, Workload and Population Data Mart.

National Denominator

IHS service population, age 18 and over.

National Numerator

Discharges age 18 and over with principal diagnosis of uncontrolled diabetes, without mention of a short-term complication (ketoacidosis, hyperosmolarity, coma) or long-term complications (renal, eye, neurologic, circulatory, other unspecified). Excludes obstetric admissions and transfers from other institutions.

Comments

Because both 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, 2007, 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, 2007, to December 31, 2007, 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.

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American Indians and Alaska Natives

Measure Title

Perforated appendixes per 1,000 admissions with appendicitis, age 18 years and over with appendicitis in IHS and tribal direct and contract hospitals and community hospitals.

Measure Source

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

Tables

18_4_2.1 Perforated appendixes per 1,000 admissions with appendicitis, age 18 and over, in Indian Health Service and tribal direct and contract hospitals and community hospitals, 2007

Data Source

Indian Health Service (IHS), Office of Information Technology/National Patient Information Reporting System (OIT/NPIRS), National Data Warehouse, Workload and Population Data Mart.

Denominator

Number of admissions with a primary or secondary diagnosis of appendicitis, excluding maternal and neonatal admissions and transfers from other institutions, age 18 and over, Indian Health Service-service population, 2007.

Numerator

Subset of the denominator with principal or secondary diagnosis of perforation or abscess of the appendix, Indian Health Service-service population, 2007.

Comments

Because both 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, 2007, based on the 2000 census.

Data for the total were age-adjusted using the 2000 U.S. 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, 2007 to December 31, 2007 inclusive.

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Hispanics or Latinos

Measure Title

Adults age 50 and over who reported they had a sigmoidoscopy, a colonoscopy, or a fecal occult blood test within the past 5 years.

Measure Source

Healthy People 2010.

Tables

18_2_1.1 Adults age 50 and over who reported they had a sigmoidoscopy, a colonoscopy, or a fecal occult blood test within the past 5 years, California, 2007, by:

  • Race
  • Ethnicity
  • Family income
  • Ethnicity

Data Source

University of California, Los Angeles (UCLA), California Health Interview Survey (CHIS).

Denominator

U.S. civilian noninstitutionalized population age 50 and over in California.

Numerator

Subset of the denominator who reported receiving a colonoscopy, sigmoidoscopy, proctoscopy, or fecal occult blood test within the past 5 years.

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Hispanics or Latinos

Measure Title

Composite measure: Adults age 40 and over with diagnosed diabetes who received all three recommended services for diabetes in the calendar year (hemoglobin A1c measurement, dilated eye examination, and foot examination).

Measure Source

Healthy People 2010.

National Alliance for Diabetes Quality Improvement, National Quality Forum, 2002.

Tables

18_5_2.1 Diabetes patients age 40 and over who had hemoglobin A1c measurement, dilated eye examination, or foot examination within the past year, California, 2007, by:

  • Race
  • Ethnicity
  • Family income
  • Ethnicity

Data Source

University of California, Los Angeles (UCLA), California Health Interview Survey (CHIS).

Denominator

U.S. civilian noninstitutionalized population age 40 and over with diabetes in California.

Numerator

Subset of the denominator who had a positive Diabetes Care Survey weight who had a Yes response to all three exams.

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Hispanics or Latinos

Measure Title

People under age 65 who were uninsured all year.

Measure Source

University of California, Los Angeles (UCLA), California Health Interview Survey (CHIS).

Tables

18_2_3.1 People under age 65 who were uninsured all year, California, 2007, by:

  • Race
  • Ethnicity
  • Family income
  • Ethnicity

Data Source

UCLA, CHIS.

Denominator

U.S. civilian noninstitutionalized population under age 65 in California.

Numerator

Subset of the denominator who reported no private or public health insurance coverage at any time during the year.

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Hispanics or Latinos

Measure Title

Adults age 18 and over who had difficulty understanding their doctor during their last visit.

Measure Source

University of California, Los Angeles (UCLA), California Health Interview Survey (CHIS).

Tables

18_2_4.1 Adults age 18 and over who had difficulty understanding their doctor during their last visit, California, 2007, by:

  • Race
  • Ethnicity
  • Family income
  • Ethnicity

Data Source

UCLA, CHIS.

Denominator

U.S. civilian noninstitutionalized population age 18 and over in California

Numerator

Subset of the denominator who had difficulty understanding their doctor during their last visit.

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Hispanics or Latinos

Measure Title

Adults age 18 and over who report language barrier as a reason for having a difficult time understanding their doctor during their last visit within the past 2 years.

Measure Source

University of California, Los Angeles (UCLA), California Health Interview Survey (CHIS).

Tables

18_2_5.1 Adults age 18 and over who report language barrier as a reason for having a difficult time understanding their doctor during their last visit within the past 2 years, California, 2007, by:

  • Race
  • Ethnicity
  • Family income
  • Ethnicity

Data Source

UCLA, CHIS.

Denominator

U.S. civilian noninstitutionalized population age 18 and over in California.

Numerator

Subset of the denominator who reported language barrier as a reason for having a difficult time understanding their doctor during their last visit within the past 2 years.

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Recent Immigrants and Limited-English-Proficient Populations

Measure Title

Patients with tuberculosis who completed a curative course of treatment within 1 year of initiation of treatment.

Measure Source

American Thoracic Society.

Centers for Disease Control and Prevention (CDC), Division of Tuberculosis Elimination.

Tables

8_2_8.2 Patients with tuberculosis who completed a curative course of treatment within one year of initiation of treatment, United States, 2005, by:

  • Race
  • Ethnicity
  • Race (foreign born only)
  • Ethnicity (foreign born only)

Data Source

CDC, National Tuberculosis Surveillance System (NTBSS).

Denominator

U.S. resident population with verified tuberculosis (TB), eligible to complete therapy within 1 year.

Numerator

TB cases completing therapy within 1 year.

Comments

See American Thoracic Society/Centers for Disease Control and Prevention/Infectious Diseases Society of America: Treatment of Tuberculosis, Am J Respir Crit Care Med, 2003, vol. 167, pp. 603-662 for further information regarding current tuberculosis treatment guidelines.

See Appendix A of CDC publication Reported Tuberculosis in the United States, 2000 for a discussion of completion of TB therapy.

Due to a change in the data source race variable effective in 2003, results have changed slightly from previous year's calculations.

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Recent Immigrants and Limited-English-Proficient Populations

Measure Title

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.

Measure Source

Agency 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).

Tables

14_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, 2006, by:

  • Race
  • Ethnicity
  • Family income
  • Education

14_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, 2006, by:

  • Race
  • Ethnicity
  • Family income
  • Education

14_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, 2006, by:

  • Race
  • Ethnicity
  • Family income
  • Education

Data Source

AHRQ, CFACT, MEPS.

Denominator

Adults age 18 and over who visited a doctor's office or clinic to get health care in the past 12 months with valid, nonmissing answer to all 4 questions that make up the composite measure.

Numerator

Subset of the denominator population in 3 categories according to their answer to the 4 questions: "Always," "Usually," "Sometimes," or "Never"

Comments

See entries for each of the 4 components of the composite measure for further details about the individual survey questions.

Percentage estimates are weighted; percentage weights are adjusted for nonresponse based on how many of the 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.

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Recent Immigrants and Limited-English-Proficient Populations

Measure Title

People under age 65 who were uninsured all year.

Measure Source

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

Tables

16_1_5.1 People under age 65 who were uninsured all year, United States, 2006, by:

  • Race
  • Ethnicity
  • Family income
  • Education

Data Source

AHRQ, CFACT, MEPS.

Denominator

U.S. civilian noninstitutionalized population under age 65.

Numerator

U.S. civilian noninstitutionalized population under age 65 who reported no private or public health insurance coverage at any time during the year.

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Recent Immigrants and Limited-English-Proficient Populations

Measure Title

Composite measure: Adults age 40 and over with diagnosed diabetes who received all three recommended services for diabetes in the calendar year (hemoglobin A1c measurement, dilated eye examination, and foot examination).

Measure Source

Healthy People 2010.

National Alliance for Diabetes Quality Improvement, National Quality Forum, 2002.

Table

18_5_2.1 Diabetes patients age 40 and over who had hemoglobin A1c measurement, dilated eye examination, and foot examination within the past year, California, 2007, by:

  • Race
  • Ethnicity
  • Family income
  • Ethnicity

Data Source

University of California, Los Angeles (UCLA), California Health Interview Survey (CHIS).

Denominator

U.S. civilian noninstitutionalized population age 40 and over with diabetes in California.

Numerator

Subset of the denominator who had a positive Diabetes Care Survey weight who had a Yes response to all three exams.

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Recent Immigrants and Limited-English-Proficient Populations

Measure Title

Adults with limited English proficiency, by whether they had a usual source of care with or without language assistance.

Measure Source

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

Table

18_6_5.1 Adults with limited English proficiency, by whether they had a usual source of care (USC) with or without language assistance, United States, 2006

Data Source

AHRQ, CFACT, MEPS.

Denominator

U.S. civilian noninstitutionalized population with limited English proficiency.

Numerator

Subset of denominator with and without a usual source of care who offers language assistance.

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Current as of March 2010
Internet Citation: Priority Populations: Racial and Ethnic Minorities: 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/racial_and_ethnic_minorities.html