Priority Populations: Rural Areas

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.


Residents of Rural Areas
Deaths per 1,000 adult hospital admissions with acute myocardial infarction (AMI).
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 who needed care right away for an illness, injury, or condition in the last 12 months who got care as soon as wanted
People under age 65 who were uninsured all year
 


Residents of Rural Areas

Measure Title

Deaths per 1,000 adult hospital admissions with acute myocardial infarction (AMI).

Measure Source

Agency for Healthcare Research and Quality (AHRQ), Inpatient Quality Indicators (IQIs).

National Tables

4_2_2.2 Deaths per 1,000 admissions with acute myocardial infarction (AMI) as principal diagnosis (excluding transfers to another hospital), age 18 and over, United States, 2006, by:�

  • Race/ethnicity

National Data Source

AHRQ, CDOM, HCUP, State Inpatient Databases, disparities analysis file.

National Denominator

All hospital inpatient discharges age 18 and over with a principal diagnosis code of AMI (International Classification of Diseases, Ninth Revision, Clinical Modification codes 410.01, 410.11, 410.21, 410.31, 410.41, 410.51, 410.61, 410.71, 410.81, 410.91). Excludes patients transferring to another short-term hospital.

National Numerator

Number of deaths with a principal diagnosis code of AMI.

Comments

Rates are adjusted by age, gender, age-gender interactions, and all patient refined-diagnosis related group (APR-DRG) risk of mortality score. When reporting is by age, the adjustment is by gender and APR-DRG risk of mortality score; when reporting is by gender, the adjustment is by age and APR-DRG risk of mortality score.

This table was created using version 3.1 of the AHRQ IQI software. This measure is referred to as IQI 15 in the software documentation. More information about the AHRQ Quality Indicators is available at http://www.qualityindicators.ahrq.gov.

Although not all States participate in the HCUP database, the Nationwide Inpatient Sample is weighted to give national estimates using weights based on all U.S. community nonrehabilitation hospitals in the American Hospital Association Annual Survey Database.

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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Residents of Rural Areas

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

2_1_1.2 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), United States, 2006, by:

  • Race.
  • Ethnicity.
  • Family income.
  • Education.

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. civilian noninstitutionalized adults age 40 and over with diabetes who had a positive Diabetes Care Survey weight, who had at least one “No” response to one of the three exams, or who had a “Yes” response to all three exams. Other cases are considered missing values.

Numerator

U.S. civilian noninstitutionalized adults age 40 and over with diabetes who had a positive Diabetes Care Survey weight who had a Yes response to all three exams.

Comments

The criteria for selecting the diabetes population from MEPS and the methodology for calculating the diabetes composite measure have changed; reported rates may not be comparable with those found in prior editions of the National Healthcare Disparities Report.

The method for defining the numerator and denominator for the eye exam component of this composite measure changed beginning with the 2008 edition of the report; rates may not be comparable with those reported in earlier editions.

Missing values for the composite measure were excluded from the analysis.

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

National estimates are age adjusted to the 2000 standard population with two age groups: 40-59, 60 and over.

The measures that make up this composite measure are referred to as measures 5-12, 5-13, and 5-14 in Healthy People 2010 documentation

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Residents of Rural Areas

Measure Title

Adults who needed care right away for an illness, injury, or condition in the last 12 months who got care as soon as wanted.

Measure Source

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

Tables

13_1_3.3 Adults who needed care right away for an illness, injury, or condition in the last 12 months who always got care as soon as wanted, United States, 2006, by:

  • Race.
  • Ethnicity.
  • Family income.
  • Education.

13_1_3.4 Adults who needed care right away for an illness, injury, or condition in the last 12 months who usually got care as soon as wanted, United States, 2006, by:

  • Race.
  • Ethnicity.
  • Family income.
  • Education.

13_1_3.5 Adults who needed care right away for an illness, injury, or condition in the last 12 months who sometimes or never got care as soon as wanted, United States, 2006, by:

  • Race.
  • Ethnicity.
  • Family income.
  • Education.

Data Source

AHRQ, CFACT, MEPS.

Denominator

Adults age 18 and over who had an illness or injury that needed care right away from a doctor's office, clinic, or emergency room in the past 12 months and also answered the question of “In the last 12 months, when you needed care right away for an illness or injury, how often did you get care as soon as you wanted?” Nonresponses and “Don't know” responses were excluded.

Numerator

Subset of the denominator population in 3 categories according to their answer to the above question: “Always,” “Usually,” “Sometimes,” or “Never.”

Comments

National tables report data from the MEPS Self-Administered Questionnaire (SAQ). See the MEPS entry in the Data Sources section of this appendix for more information on the SAQ.

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Residents of Rural Areas

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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Current as of March 2010
Internet Citation: Priority Populations: Rural Areas: 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/rural_areas.html