Health Care Utilization

2010 National Healthcare Quality and Disparities Reports

Access to Care: Health Care Utilization

General Medical Care
People who had an office-based or outpatient department visit in the calendar year
People who received a prescription medication in the calendar year
People who had a dental visit in the calendar year
People who had a hospital emergency room visit
People who received a hospital inpatient discharge
Physician office and hospital outpatient visits
Emergency department visits
Hospitalizations per 100 population

Potentially Avoidable Admissions
Avoidable admissions for hypertension among adults
Avoidable admissions for angina among adults
Avoidable admissions for chronic obstructive pulmonary disease among adults
Avoidable admissions for bacterial pneumonia among adults
Avoidable admissions for bacterial pneumonia among adults in Hawaii
Perforated appendixes per 1,000 admissions with appendicitis
Perforated appendixes per 1,000 admissions with appendicitis, Indian Health Service

Mental Health Care and Substance Abuse Treatment
Adults who received mental health treatment or counseling in the last 12 months
Adults who received outpatient mental health treatment or counseling in the last 12 months
Adults who received prescription medications for mental health treatment in the last 12 months
Adults who received inpatient mental health treatment or counseling in the last 12 months
People age 12 and over who received any treatment for illicit drug or alcohol abuse in the last 12 months

General Medical Care

Measure Title

People who had an office-based or outpatient department visit in the calendar year.

Measure Source

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

National Tables

17_1_1.1: People who had an office-based or outpatient department visit, United States, 2002-2007

17_1_1.2a-d People who had an office-based or outpatient department visit in the calendar year, United States, 2007, by:

• Race.
• Ethnicity.
• Family Income.
• Education.

National Data Source

AHRQ, CFACT, MEPS.

National Denominator

U.S. civilian noninstitutionalized population.

National Numerator

Subset of the denominator who reported at least one office-based/outpatient department visit.

Comments

Office-based/outpatient department visits include the following:

• Office-based visits to physician and nonphysician providers..
• Outpatient department visits to physician and nonphysician providers..
• Inpatient visits where the admission date was the same as the discharge date (i.e., "zero night" stays)..

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General Medical Care

Measure Title

People who received a prescription medication in the calendar year.

Measure Source

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

National Tables

17_1_2.1 People who received a prescription medication, United States, 2002-2007

17_1_2.2a-d People who received a prescription medication in the calendar year, United States, 2007, by:

• Race.
• Ethnicity.
• Family Income.
• Education.

National Data Source

AHRQ, CFACT, MEPS.

National Denominator

U.S. civilian noninstitutionalized population.

National Numerator

Subset of the denominator who reported receiving at least one prescribed medication.

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General Medical Care

Measure Title

People who had a dental visit in the calendar year.

Measure Source

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

National Tables

17_1_3.1 People who had a dental visit, United States, 2002-2007

17_1_3.2a-d People who had a dental visit in the calendar year, United States, 2007

• Race.
• Ethnicity.
• Family Income.
• Education.

National Data Source

AHRQ, CFACT, MEPS.

National Denominator

U.S. civilian noninstitutionalized population.

National Numerator

Subset of the denominator who reported at least one dental visit during the calendar year.

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General Medical Care

Measure Title

People who had a hospital emergency room visit.

Measure Source

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

National Tables

17_1_4.1 People who had a hospital emergency room visit, United States, 2002-2007

17_1_4.2a-d People who had a hospital emergency room visit in the calendar year, United States, 2007, by:

• Race.
• Ethnicity.
• Family Income.
• Education.

National Data Source

AHRQ, CFACT, MEPS.

National Denominator

U.S. civilian noninstitutionalized population.

National Numerator

Subset of denominator who reported at least one emergency room visit during the calendar year.

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General Medical Care

Measure Title

People with a hospital inpatient discharge.

Measure Source

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

National Tables

17_1_5.1 People who had a hospital inpatient discharge, United States, 2002-2007

17_1_5.2a-d People who had a hospital inpatient discharge in the calendar year, United States, 2007, by:

• Race.
• Ethnicity.
• Family Income.
• Education.

National Data Source

AHRQ, CFACT, MEPS.

National Denominator

U.S. civilian noninstitutionalized population.

National Numerator

Subset of denominator who reported at least one inpatient discharge during the calendar year.

Comments

Inpatient discharges exclude inpatient visits where the admission date was the same as the discharge date (i.e., "zero night" stays).

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General Medical Care

Measure Title

Physician office and hospital outpatient visits.

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

17_1_6.1 Physician office and hospital outpatient department visits per 100 population, United States, 1999-2008

17_1_6.2a Physician office and hospital outpatient visits per 100 population, United States, 2007-2008, by:

• Race.

National Data Source

CDC, NCHS, NAMCS, NHAMCS.

National Denominator

U.S. civilian noninstitutionalized population.

National Numerator

Number of visits to physician offices and hospital outpatient departments among the population represented by the denominator.

Comments

Year 2006 and 2007 rates use U.S. Census Bureau estimates of the civilian noninstitutionalized population as of July 1, 2006, and July 1, 2007, and are based on data from Census 2000.

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General Medical Care

Measure Title

Emergency department visits.

Measure Source

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

National Tables

17_1_7.1 Emergency department visits per 100 population, United States, 2001-2008

17_1_7.2 Emergency department visits per 100 population, United States, 2007-2008, by:

• Race.

National Data Source

CDC, NCHS, NHAMCS.

National Denominator

U.S. civilian noninstitutionalized population.

National Numerator

Number of visits to a hospital emergency department among the population in the denominator.

Comments

Estimates of the civilian noninstitutionalized population are from special tabulations developed by the Population Division, U.S. Census Bureau, using estimates as of July 1 of the period of study and are based on Census 2000 data.

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General Medical Care

Measure Title

Hospitalizations per 100 population.

Measure Source

Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS), National Hospital Discharge Survey (NHDS).

National Tables

17_1_8.1 Hospitalizations per 100 population, United States, 2000-2007

17_1_8.2 Hospitalizations per 100 population, United States, 2007, by:

• Race.

Data Source

CDC, NCHS, NHDS.

National Denominator

U.S. civilian noninstitutionalized population.

Numerator

Number of hospital discharges among the population in the denominator.

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Potentially Avoidable Admissions

Measure Title

Avoidable admissions for hypertension among adults.

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

17_2_1.1 Admissions for hypertension per 100,000 population, age 18 and over, United States, 2000, 2004-2007

17_2_1.2 Admissions for hypertension per 100,000 population, age 18 and over, United States, 2007, by:

• Race/ethnicity.

National Data Source

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

National Denominator

Adult U.S. population age 18 and over.

National Numerator

Subset of the denominator with principal diagnosis of hypertension (ICD-9-CM codes 401.0, 401.9, 402.00-402.90, 403.00-403.90, 404.00-404.90), excluding patients with cardiac procedures, obstetric admissions, and transfers from other institutions.

State Table

17_2_1.3 Admissions for hypertension per 100,000 population, age 18 and over, by State, 2002, 2004-2007

State Data Source

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

State Denominator

Same as National.

State Numerator

Same as National.

Comments

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

This table was created using version 3.1 of the AHRQ PQI software. This measure is referred to as PQI 7 in the software documentation. More information about the AHRQ Quality Indicators is available at http://www.qualityindicators.ahrq.gov.

State estimates are from the State Inpatient Databases (SID), and not all States participate in HCUP. Estimates for the total United States are from the NIS, which is drawn from the SID and weighted to give national estimates.

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 Admissions

Measure Title

Avoidable admissions for angina among adults.

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

17_2_2.1 Admissions for angina without procedure per 100,000 population, age 18 and over, United States, 2000, 2004-2007

Table 17_2_2.2 Admissions for angina without procedure per 100,000 population, age 18 and over, United States, 2007

• Race/ethnicity.

National Data Source

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

National Denominator

U.S. population age 18 and over.

National Numerator

Subset of the denominator with principal diagnosis of angina (ICD-9-CM codes 411.1—411.89, 413.0-413.9), excluding patients with cardiac procedures, obstetric admissions, and transfers from other institutions.

State Table

17_2_2.3 Admissions for angina without procedure per 100,000 population, age 18 and over, by State, 2000, 2004-2007

State Data Source

AHRQ, CDOM, HCUP State Inpatient databases (SID) and AHRQ Quality Indicators, version 3.1.

State Denominator

Same as National.

State Numerator

Same as National.

Comments

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

This table was created using version 3.1 of the AHRQ PQI software. This measure is referred to as PQI 13 in the software documentation. More information about the AHRQ Quality Indicators is available at http://www.qualityindicators.ahrq.gov.

State estimates are from the SID, and not all States participate in HCUP. Estimates for the total United States are from the NIS, which is drawn from the SID and weighted to give national estimates.

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 Admissions

Measure Title

Avoidable admissions for chronic obstructive pulmonary disease among adults.

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

17_2_3.1 Admissions for chronic obstructive pulmonary disease per 100,000 population, age 18 and over, United States, 2000, 2004-2007

17_2_3.2 Admissions for chronic obstructive pulmonary disease per 100,000 population, age 18 and over, United States, 2007, by:

• Race/ethnicity.

National Data Source

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

National Denominator

U.S. population age 18 and over.

National Numerator

Subset of the denominator with principal diagnosis of chronic obstructive pulmonary disease (ICD-9-CM codes 490, 466.0, 491.0-491.21, 491.8, 491.9, 492.0, 492.8, 494, 494.0, 494.1, 496), excluding obstetric admissions and transfers from other institutions.

State Table

17_2_3.3 Admissions for chronic obstructive pulmonary disease per 100,000 population, age 18 and over, by State, 2004-2007

State Data Source

AHRQ, CDOM, HCUP State Inpatient Databases (SID) and AHRQ Quality Indicators, version 3.1.

State Denominator

Same as National.

State Numerator

Same as National.

Comments

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

This table was created using version 3.1 of the AHRQ PQI software. This measure is referred to as PQI 5 in the software documentation. More information about the AHRQ Quality Indicators is available at http://www.qualityindicators.ahrq.gov.

State estimates are from the SID, and not all States participate in HCUP. Estimates for the total United States are from the NIS, which is drawn from the SID and weighted to give national estimates.

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 Admissions

Measure Title

Avoidable admissions for bacterial pneumonia among adults.

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

17_2_4.1 Bacterial pneumonia admissions per 100,000 population, age 18 and over, United States, 2000, 2004-2007

17_2_4.2 Bacterial pneumonia admissions per 100,000 population, age 18 and over, by United States, 2007, by:

• Race/ethnicity.

National Data Source

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

National Denominator

U.S. population age 18 and over.

National Numerator

Subset of the denominator with a principal diagnosis of bacterial pneumonia (ICD-9-CM codes 481, 482.2-483.8, 485, 486), excluding sickle cell or hemoglobin-S conditions, obstetric admissions, and transfers from other institutions.

State Table

17_2_4.3 Bacterial pneumonia admissions per 100,000 population, age 18 and over, by State, 2000

State Data Source

AHRQ, CDOM, HCUP State Inpatient Databases (SID) and AHRQ Quality Indicators, version 3.1.

State Denominator

Same as National.

State Numerator

Same as National.

Comments

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

This table was created using version 3.1 of the AHRQ PQI software. This measure is referred to as PQI 11 in the software documentation. More information about the AHRQ Quality Indicators is available at http://www.qualityindicators.ahrq.gov.

State estimates are from the SID, and not all States participate in HCUP. Estimates for the total United States are from the NIS, which is drawn from the SID and weighted to give national estimates.

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 Admissions

Measure Title

Avoidable admissions for bacterial pneumonia among adults in Hawaii.

Measure Source

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

National Table

17_2_4.4 Bacterial pneumonia admissions per 100,000 population, age 18 and over, by race/ethnicity, Hawaii, 2005-2007

National Data Source

AHRQ, CDOM, HCUP, Hawaii State Inpatient Databases (SID) and AHRQ Quality Indicators, version 3.1.

National Denominator

Hawaii population age 18 and over.

National Numerator

Subset of denominator with principal diagnosis of bacterial pneumonia.

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Potentially Avoidable Admissions

Measure Title

Perforated appendixes per 1,000 admissions with appendicitis.

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

17_2_5.1 Admissions with perforated appendix per 1,000 admissions with appendicitis, age 18 and over, United States, 2000, 2004-2007

17_2_5.2 Admissions with perforated appendix per 1,000 admissions with appendicitis, ages 1-17, United States, 2000, 2004-2007

17_2_5.3 Admissions with perforated appendix per 1,000 admissions with appendicitis, age 18 and over, United States, 2007

• Race/ethnicity.

17_2_5.4 Admissions with perforated appendix per 1,000 admissions with appendicitis, ages 1-17, United States, 2007, by:

• Race/ethnicity.

National Data Source

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

National Denominator

Nonmaternal discharges with principal or secondary diagnosis of appendicitis, excluding transfer from other institutions.

National Numerator

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

State Table

17_2_5.5 Admissions with perforated appendix per 1,000 admissions with appendicitis, age 18 and over, by State, 2000, 2004-2007

17_2_5.6 Admissions with perforated appendix per 1,000 admissions with appendicitis, ages 1-17, by State, 2000

State Data Source

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

State Denominator

Same as National.

State Numerator

Same as National.

Comments

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

This table was created using version 3.1 of the AHRQ PQI software. This measure is referred to as PQI 2 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 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 Admissions

Measure Title

Perforated appendixes per 1,000 admissions with appendicitis, Indian Health Service.

Measure Source

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

National Table

17_2_5.7 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, 2003-2008

National Data Source

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

National Denominator

Adult population over 18 admitted to Indian Health Service and tribal direct and contract hospitals and community hospitals with a diagnosis of appendicitis.

National Numerator

Subset of denominator with a diagnosis of a perforated appendix.

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Mental Health Care and Substance Abuse Treatment

Measure Title

Adults who received mental health treatment or counseling in the last 12 months.

Measure Source

Substance Abuse and Mental Health Services Administration (SAMHSA), Office of Applied Studies, National Survey on Drug Use and Health (NSDUH).

National Tables

17_3_1.1 Adults who received mental health treatment or counseling in the last 12 months, 2002-2008

17_3_1.2a-d Adults who received mental health treatment or counseling in the last 12 months, 2008, by:

• Race.
• Ethnicity.
• Family Income.
• Education.

National Data Source

SAMHSA, NSDUH.

National Denominator

U.S. civilian noninstitutionalized populations age 18 and over.

National Numerator

Subset of the denominator who reported receipt of mental health treatment or counseling in the past year.

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Mental Health Care and Substance Abuse Treatment

Measure Title

Adults who received outpatient mental health treatment or counseling in the last 12 months.

Measure Source

Substance Abuse and Mental Health Services Administration (SAMHSA), Office of Applied Studies, National Survey on Drug Use and Health (NSDUH).

National Tables

17_3_2.1 Adults who received outpatient mental health treatment or counseling in the last 12 months, 2002-2008

17_3_2.2a-d Adults who received outpatient mental health treatment or counseling in the last 12 months, 2008, by:

• Race.
• Ethnicity.
• Family Income.
• Education.

National Data Source

SAMHSA, NSDUH.

National Denominator

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

Numerator

Subset of the denominator who reported receipt of outpatient mental health treatment or counseling in the past year.

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Mental Health Care and Substance Abuse Treatment

Measure Title

Adults who received prescription medications for mental health treatment in the last 12 months.

Measure Source

Substance Abuse and Mental Health Services Administration (SAMHSA), Office of Applied Studies, National Survey on Drug Use and Health (NSDUH).

National Tables

17_3_3.1 Adults who received prescription medications for mental health treatment in the last 12 months, 2002-2008

17_3_3.2.a-d Adults who received prescription medications for mental health treatment in the last 12 months, 2008, by:

• Race.
• Ethnicity.
• Family Income.
• Education.

National Data Source

SAMHSA, NSDUH.

National Denominator

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

Numerator

Subset of the denominator who reported receipt of prescription medications for mental health treatment or counseling in the past year.

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Mental Health Care and Substance Abuse Treatment

Measure Title

Adults who received inpatient mental health treatment or counseling in the last 12 months.

Measure Source

Substance Abuse and Mental Health Services Administration (SAMHSA), Office of Applied Studies, National Survey on Drug Use and Health (NSDUH).

National Table

17_3_4.1 Adults who received inpatient mental health treatment or counseling in the last 12 months, 2002- 2007

National Data Source

SAMHSA, NSDUH.

National Denominator

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

Numerator

Subset of the denominator who reported receipt of inpatient mental health treatment or counseling in the past year.

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Mental Health Care and Substance Abuse Treatment

Measure Title

People age 12 and over who received any treatment for illicit drug or alcohol abuse in the last 12 months.

Measure Source

Substance Abuse and Mental Health Services Administration (SAMHSA), Office of Applied Studies, National Survey on Drug Use and Health (NSDUH).

National Tables

17_3_5.1 People age 12 and over who received any illicit drug or alcohol abuse treatment in the last 12 months, 2002-2008

17_3_5.2a-d People age 12 and over who received any illicit drug or alcohol abuse treatment in the last 12 months, 2008, by:

• Race.
• Ethnicity.
• Family Income.
• Education.

National Data Source

SAMHSA, NSDUH.

National Denominator

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

Numerator

Subset of the denominator who received treatment for illicit drug or alcohol abuse in the past year.

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