Efficiency

2010 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.

Efficiency

Potentially Avoidable Hospitalizations and Cost
Potentially avoidable hospitalizations for acute, chronic, and all conditions
Potentially avoidable hospitalizations
Potentially avoidable hospitalizations for acute conditions
Potentially avoidable hospitalizations for chronic conditions
Potentially avoidable hospitalizations for all conditions, by State
Potentially avoidable hospitalizations for acute conditions, by State
Potentially avoidable hospitalizations for chronic conditions, by State

Potentially Avoidable Emergency Encounters
Potentially avoidable emergency department encounters for adults with asthma
Potentially avoidable emergency department encounters for children with asthma

Reduction of Unnecessary Costs
Ambulatory medical care visits where antibiotics were prescribed for a diagnosis of a common cold
Doctor's office, emergency department, and outpatient department visits where antibiotics were prescribed for a diagnosis of a common cold

Potentially Avoidable Hospitalizations

Measure Title

Potentially avoidable hospitalizations for acute, chronic, and all conditions.

Measure Source

Agency for Healthcare Research and Quality (AHRQ), Center for Delivery, Organization, and Markets (CDOM), Healthcare Cost and Utilization Project (HCUP), Nationwide Inpatient Sample (NIS) and AHRQ Quality Indicators, version 3.1.

National Tables

15_1_1.1 Potentially avoidable hospitalizations per 100,000 population for all conditions, age 18 and over, United States, 2000, 2004-2007

15_1_1.2 Potentially avoidable hospitalizations per 100,000 population for acute conditions, age 18 and over, United States, 2000, 2004-2007

15_1_1.3 Potentially avoidable hospitalizations per 100,000 population for chronic conditions, age 18 and over, United States, 2000, 2004-2007

National Data Source

AHRQ, CDOM, HCUP, NIS, AHRQ Quality Indicators, version 3.1.

National Denominator

U.S. population age 18 and over.

National Numerator

Number of hospitalizations, age 18 and over, who qualified for any individual PQI numerator: 1, 3, 5, 7, 8, 10, 11, 12, 13, 14, 15, and 16 (Table 15_1_1).

Number of hospitalizations, age 18 and over, who qualified for any individual PQI numerator considered acute: 10, 11, and 12 (Table 15_1_2).

Number of hospitalizations, age 18 and over, who qualified for any individual PQI numerator considered chronic: 1, 3, 5, 7, 8, 13, 14, 15, and 16 (Table 15_1_3).

PQI components of the composites include:

  • .
  • PQI 1: Diabetes, short-term complications.
  • PQI 3: Diabetes, long-term complications.
  • PQI 5: Chronic obstructive pulmonary disease.
  • PQI 7: Hypertension.
  • PQI 8: Congestive heart failure.
  • PQI 10: Dehydration.
  • PQI 11: Bacterial pneumonia.
  • PQI 12: Urinary infections.
  • PQI 13: Angina without procedure.
  • PQI 14: Uncontrolled diabetes.
  • PQI 15: Adult asthma.
  • PQI 16: Lower extremity amputations among patients with diabetes.

Comments

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

This table was created using version 3.1 of the AHRQ PQI software. For additional information, refer to http://www.qualityindicators.ahrq.gov/.

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Potentially Avoidable Hospitalizations

Measure Title

Potentially avoidable hospitalizations.

Measure Source

Agency for Healthcare Research and Quality (AHRQ), Center for Delivery, Organization, and Markets (CDOM), Healthcare Cost and Utilization Project (HCUP), State Inpatient Databases (SID), disparities analysis file, 2007, and AHRQ Quality Indicators, version 3.1.

National Table

15_1_1.4 Potentially avoidable hospitalizations per 100,000 population for all conditions, age 18 and over, United States, 2007, by:

  • Race/ethnicity.

National Data Source

AHRQ, CDOM, HCUP, SID, AHRQ Quality Indicators, version 3.1.

Denominator

U.S. civilian population age 18 and over.

Numerator

Subset of denominator who were admitted to a hospital for potentially avoidable hospitalizations for all conditions.

Number of hospitalizations, age 18 and over, who qualified for any individual PQI numerator: 1, 3, 5, 7, 8, 10, 11, 12, 13, 14, 15, and 16.

PQI components of the composite include:

  • PQI 1: Diabetes, short-term complications.
  • PQI 3: Diabetes, long-term complications.
  • PQI 5: Chronic obstructive pulmonary disease.
  • PQI 7: Hypertension.
  • PQI 8: Congestive heart failure.
  • PQI 10: Dehydration.
  • PQI 11: Bacterial pneumonia.
  • PQI 12: Urinary infections.
  • PQI 13: Angina without procedure.
  • PQI 14: Uncontrolled diabetes.
  • PQI 15: Adult asthma.
  • PQI 16: Lower extremity amputations among patients with diabetes.

Comments

The SID disparities analysis file, created specifically for the NHQR/NHDR to provide national estimates on disparities, consists of weighted records from a sample of hospitals from the following 26 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, WI, and WY.

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Potentially Avoidable Hospitalizations

Measure Title

Potentially avoidable hospitalizations for acute conditions.

Measure Source

Agency for Healthcare Research and Quality (AHRQ), Center for Delivery, Organization, and Markets (CDOM), Healthcare Cost and Utilization Project (HCUP), State Inpatient Databases (SID), disparities analysis file, 2007, and AHRQ Quality Indicators, version 3.1.

National Table

15_1_1.5 Potentially avoidable hospitalizations per 100,000 population for acute conditions, age 18 and over, United States, 2007, by:

  • Race/ethnicity.

National Data Source

AHRQ, CDOM, HCUP, SID AHRQ Quality Indicators, version 3.1.

National Denominator

U.S. civilian population age 18 and over.

National Numerator

Subset of denominator who were admitted to a hospital for potentially avoidable hospitalizations for acute conditions.

Number of hospitalizations, age 18 and over, who qualified for any individual PQI numerator considered acute: 10, 11, and 12.

PQI components of the composite include:

  • PQI 10: Dehydration.
  • PQI 11: Bacterial pneumonia.
  • PQI 12: Urinary infections.

Comments

The SID disparities analysis file, created specifically for the NHQR/NHDR to provide national estimates on disparities, consists of weighted records from a sample of hospitals from the following 26 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, WI, and WY.

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Potentially Avoidable Hospitalizations

Measure Title

Potentially avoidable hospitalizations for chronic conditions.

Measure Source

Agency for Healthcare Research and Quality (AHRQ), Center for Delivery, Organization, and Markets (CDOM), Healthcare Cost and Utilization Project (HCUP), State Inpatient Databases (SID), disparities analysis file, 2007, and AHRQ Quality Indicators, version 3.1.

National Table

15_1_1.6 Potentially avoidable hospitalizations per 100,000 population for chronic conditions, age 18 and over, United States, 2007 by:

  • Race/ethnicity.

National Data Source

AHRQ, CDOM, HCUP, SID, AHRQ Quality Indicators, version 3.1.

National Denominator

U.S. civilian population age 18 and over.

National Numerator

Subset of denominator who were admitted to a hospital for potentially avoidable hospitalizations for chronic conditions.

Number of hospitalizations, age 18 and over, who qualified for any individual PQI numerator considered chronic: 1, 3, 5, 7, 8, 13, 14, 15, and 16.

PQI components of the composite include:

  • PQI 1: Diabetes, short-term complications.
  • PQI 3: Diabetes, long-term complications.
  • PQI 5: Chronic obstructive pulmonary disease.
  • PQI 7: Hypertension.
  • PQI 8: Congestive heart failure.
  • PQI 13: Angina without procedure.
  • PQI 14: Uncontrolled diabetes.
  • PQI 15: Adult asthma.
  • PQI 16: Lower extremity amputations among patients with diabetes.

Comments

The SID disparities analysis file, created specifically for the NHQR/NHDR to provide national estimates on disparities, consists of weighted records from a sample of hospitals from the following 26 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, WI, and WY.

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Potentially Avoidable Hospitalizations

Measure Title

Potentially avoidable hospitalizations for all conditions, by State.

Measure Source

Agency for Healthcare Research and Quality (AHRQ), Center for Delivery, Organization, and Markets (CDOM), Healthcare Cost and Utilization Project (HCUP), Nationwide Inpatient Sample (NIS) and AHRQ Quality Indicators, version 3.1.

State Table

15_1_1.7 Potentially avoidable hospitalizations per 100,000 population for all conditions, age 18 and over, by State, 2006-2007

State Data Source

AHRQ, CDOM, HCUP, SID, AHRQ Quality Indicators, version 3.1.

State Denominator

U.S. civilian population age 18 and over.

State Numerator

Subset of denominator who were admitted to a hospital for potentially avoidable hospitalizations for all conditions.

PQI components of the composite include:

  • PQI 1: Diabetes, short-term complications.
  • PQI 3: Diabetes, long-term complications.
  • PQI 5: Chronic obstructive pulmonary disease.
  • PQI 7: Hypertension.
  • PQI 8: Congestive heart failure.
  • PQI 10: Dehydration.
  • PQI 11: Bacterial pneumonia.
  • PQI 12: Urinary infections.
  • PQI 13: Angina without procedure.
  • PQI 14: Uncontrolled diabetes.
  • PQI 15: Adult asthma.
  • PQI 16: Lower extremity amputations among patients with diabetes.

Comments

State estimates are from the State Inpatient Databases (SID). Not all States participate in HCUP.

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Potentially Avoidable Hospitalizations

Measure Title

Potentially avoidable hospitalizations for acute conditions, by State.

Measure Source

Agency for Healthcare Research and Quality (AHRQ), Center for Delivery, Organization, and Markets (CDOM), Healthcare Cost and Utilization Project (HCUP), Nationwide Inpatient Sample (NIS) and AHRQ Quality Indicators, version 3.1.

State Table

15_1_1.8 Potentially avoidable hospitalizations per 100,000 population for acute conditions, age 18 and over, by State, 2006-2007

State Data Source

AHRQ, CDOM, HCUP, NIS. AHRQ Quality Indicators, version 3.1.

State Denominator

U.S. civilian population age 18 and over.

State Numerator

Subset of denominator who were admitted to a hospital for potentially avoidable hospitalizations for acute conditions.

PQI components of the composite include:

  • PQI 10: Dehydration.
  • PQI 11: Bacterial pneumonia.
  • PQI 12: Urinary infections.

Comments

State estimates are from the State Inpatient Databases (SID). Not all States participate in HCUP.

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Potentially Avoidable Hospitalizations

Measure Title

Potentially avoidable hospitalizations for chronic conditions, by State.

Measure Source

Agency for Healthcare Research and Quality (AHRQ), Center for Delivery, Organization, and Markets (CDOM), Healthcare Cost and Utilization Project (HCUP), Nationwide Inpatient Sample (NIS) and AHRQ Quality Indicators, version 3.1.

State Table

15_1_1.9 Potentially avoidable hospitalizations per 100,000 population for chronic conditions, age 18 and over, by State, 2006-2007

State Data Source

AHRQ, CDOM, HCUP, NIS and AHRQ Quality Indicators, version 3.1.

State Denominator

U.S. civilian population age 18 and over.

State Numerator

Subset of denominator who were admitted to a hospital for potentially avoidable hospitalizations for chronic conditions.

PQI components of the composite include:

  • PQI 1: Diabetes, short-term complications.
  • PQI 3: Diabetes, long-term complications.
  • PQI 5: Chronic obstructive pulmonary disease.
  • PQI 7: Hypertension.
  • PQI 8: Congestive heart failure.
  • PQI 13: Angina without procedure.
  • PQI 14: Uncontrolled diabetes.
  • PQI 15: Adult asthma.
  • PQI 16: Lower extremity amputations among patients with diabetes.

Comments

State estimates are from the State Inpatient Databases (SID). Not all States participate in HCUP.

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Potentially Avoidable Emergency Encounters

Measure Title

Potentially avoidable emergency department encounters for adults with asthma.

Measure Source

Agency for Healthcare Research and Quality (AHRQ), Center for Delivery, Organization, and Markets (CDOM), Healthcare Cost and Utilization Project (HCUP), Nationwide Inpatient Sample (NIS) and Nationwide Emergency Department Sample (NEDS), 2007, and AHRQ Quality Indicators, version 3.1.

National Table

15_1_6.1 Emergency department visits for asthma per 100,000 population, age 18 and over, United States, 2007

National Data Source

AHRQ, CDOM, HCUP, NIS, NEDS, AHRQ Quality Indicators, version 3.1.

National Denominator

U.S. civilian population age 18 and over.

National Numerator

Subset of denominator with an emergency department asthma visit.

Comment

For additional information on AHRQ Quality Indicators refer to http://www.qualityindicators.ahrq.gov/.

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Potentially Avoidable Emergency Encounters

Measure Title

Potentially avoidable emergency department encounters for children with asthma.

Measure Source

Agency for Healthcare Research and Quality (AHRQ), Center for Delivery, Organization, and Markets (CDOM), Healthcare Cost and Utilization Project (HCUP), Nationwide Inpatient Sample (NIS) and Nationwide Emergency Department Sample (NEDS), 2007, and AHRQ Quality Indicators, version 3.1.

National Table

15_1_6.2 Emergency department visits per 100,000 population, ages 2-17, United States, 2007

National Data Source

AHRQ, CDOM, HCUP, NIS, NEDS, AHRQ Quality Indicators, version 3.1.

National Denominator

U.S. civilian population ages 2-17.

National Numerator

Subset of denominator with an emergency department asthma visit.

Comment

For additional information on AHRQ Quality Indicators refer to http://www.qualityindicators.ahrq.gov/.

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Reduction of Unnecessary Costs

Measure Title

Ambulatory medical care visits where antibiotics were prescribed for a diagnosis of common cold.

Measure Source

Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS), National Ambulatory Medical Care Survey (NAMCS) and National Hospital Ambulatory Medical Care Survey (NHAMCS).

National Table

15_2_1.1 Antibiotic prescribing at ambulatory medical care visits for colds per 10,000 population, United States, 2005-2008

National Data Source

CDC, NCHS, NAMCS, NHAMCS.

National Denominator

U.S. civilian noninstitutionalized population.

National Numerator

Subset of denominator with a diagnosis of a common cold who received an antibiotic prescription during an ambulatory medical care visit.

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Reduction of Unnecessary Costs

Measure Title

Doctor's office, emergency department, and outpatient department visits where antibiotics were prescribed for a diagnosis of a common cold.

Measure Source

Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS), National Ambulatory Medical Care Survey (NAMCS) and National Hospital Ambulatory Medical Care Survey (NHAMCS).

National Tables

15_2_1.2 Doctor's office, emergency department, and outpatient department visits where antibiotics were prescribed for a diagnosis of a common cold, per 10,000 population, United States, 1997-2007

15_2_1.3a Doctor's office, emergency department, and outpatient department visits where antibiotics were prescribed for a diagnosis of common cold per 10,000 population, United States, 2007-2008, by:

  • Race.

National Data Source

CDC, NCHS, NAMCS, NHAMCS.

National Denominator

U.S. civilian noninstitutionalized population.

National Numerator

Subset of the denominator diagnosed with the common cold (ICD-9-CM codes 460.0, 465, or 472.0) for whom an antibiotic course was ordered, supplied, administered, or continued.

Comments

This measure is referred to as measure 14-19 in Healthy People 2010 documentation.

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AHRQAdvancing Excellence in Health Care
Current as of February 2011
Internet Citation: Efficiency: 2010 National Healthcare Quality and Disparities Reports. February 2011. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/research/findings/nhqrdr/nhqrdr10/measurespec/efficiency.html