Effectiveness: Respiratory Diseases

2010 National Healthcare Quality and Disparities Reports

Effectiveness of Care: Respiratory Diseases

Vaccinations for Respiratory Infections
Adults ages 18-64 at high risk who received an influenza vaccination in the last 12 months
Adults age 65 and over who received an influenza vaccination in the last 12 months
Hospital admissions for immunization-preventable influenza per 100,000 population age 65 and over
Adults ages 18-64 at high risk who ever received pneumococcal vaccination
Adults age 65 and over who ever received pneumococcal vaccination

Treatment of Respiratory Infections
Hospital patients with pneumonia who received recommended hospital care (blood cultures collected before antibiotics are administered, initial antibiotic dose within 6 hours of hospital arrival and consistent with current recommendations, and influenza and pneumococcal screening or vaccination)
Hospital patients with pneumonia who had blood cultures collected before antibiotics were administered
Hospital patients with pneumonia who received the initial antibiotic dose within 6 hours of arrival
Hospital patients with pneumonia who received the initial antibiotic consistent with current recommendations
Hospital patients with pneumonia who received influenza screening or vaccination
Hospital patients with pneumonia who received pneumococcal screening or vaccination
Deaths per 1,000 adult hospital admissions with pneumonia
Patients with tuberculosis who completed a curative course of treatment within 1 year of initiation of treatment

Management of Asthma
People with current asthma who are now taking preventive medicine daily or almost daily (either oral or inhaler)
People with asthma who were taking prescription medication to control asthma during the past 12 months
Hospital admissions for asthma per 100,000 population by age group

Vaccinations for Respiratory Infections

Measure Title

Adults ages 18-64 at high risk who received an influenza vaccination in the last 12 months.

Measure Source

Healthy People 2010.

National Tables

8_1_1.1 Adults ages 18-64 at high risk who received an influenza vaccination in the last 12 months, United States, 2004-2008

8_1_1.2 Adults ages 18-64 at high risk who received an influenza vaccination in the last 12 months, United States, 1999-2004

8_1_1.3a-c Adults ages 18-64 at high risk who received an influenza vaccination in the last 12 months, United States, 2008, by:

• Race.
• Ethnicity.
• Family Income.

National Data Source

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

National Denominator

U.S. civilian noninstitutionalized population ages 18-64 who have a high risk condition.

National Numerator

Subset of denominator who report receiving an influenza vaccination in the past 12 months.

State Table

8_1_1.4 Adults ages 18-64 at high risk (e.g., COPD) who received an influenza vaccination in the last 12 months, by State, 2003 and 2007

State Data Source

CDC, Behavioral Risk Factor Surveillance System (BRFSS).

State Denominator

Number of high-risk persons ages 18-64.

State Numerator

Number of high-risk persons ages 18-64 who answered "yes" to the question: "During the past 12 months, have you had a flu shot?"

Comments

This measure is referred to as measure 14-29c in Healthy People 2010 documentation.

High-risk conditions include diabetes, heart disease, lung disease, kidney disease, liver disease, and cancer. Not all high-risk conditions for complications of influenza can be ascertained by NHIS (e.g., immunocompromised), and the sample size may be too small for some groups.

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.

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

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Vaccinations for Respiratory Infections

Measure Title

Adults age 65 and over who received an influenza vaccination in the last 12 months.

Measure Source

Healthy People 2010.

National Tables

8_1_2.1 Adults age 65 and over who received an influenza vaccination in the last 12 months, United States, 2005-2008

8_1_2.2 Adults age 65 and over who received an influenza vaccination in the last 12 months, United States, 1999-2004

8_1_2.3a-c Adults age 65 and over who received an influenza vaccination in the last 12 months, United States, 2008, by:

• Race.
• Ethnicity.
• Family Income.

National Data Source

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

National Denominator

U.S. civilian noninstitutionalized population of adults age 65 and over.

National Numerator

Number of adults age 65 and over who report receiving an influenza vaccination in the past 12 months.

State Table

8_1_2.4 Adults age 65 and over who received an influenza vaccination in the last 12 months, by State, 2001-2008

State Data Source

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

State Denominator

Number of adults age 65 and over.

State Numerator

Subset of denominator who reported receiving an influenza vaccination in the past 12 months.

Comments

This measure is referred to as measure 14-29a in Healthy People 2010 documentation.

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 one of the components of the Immunization Leading Health Indicators, which further defines the measure as pertaining to high-risk adults. See Appendix H of Tracking Healthy People 2010 for a complete listing of Leading Health Indicators.

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Vaccinations for Respiratory Infections

Measure Title

Hospital admissions for immunization-preventable influenza per 100,000 population age 65 and over.

Measure Source

Healthy People 2010.

National Tables

8_1_3.1 Immunization-preventable influenza admissions per 100,000 population, age 65 and over, United States, 2000, 2004-2007

8_1_3.2 Immunization-preventable influenza admissions per 100,000 population, age 65 and over, United States, 2007, by:

• Race/ethnicity.

National Data Source

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

National Denominator

U.S. population age 65 and over.

National Numerator

Subset of denominator with any diagnosis of immunization-preventable influenza (ICD-9-CM codes 487.0, 487.1, and 487.8), excluding transfers from other institutions.

State Table

8_1_3.3 Immunization-preventable influenza admissions per 100,000 population, age 65 and over, by State, 2000, 2004-2007.

State Data Source

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

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 measure is referred to as measure 1-9c in Healthy People 2010 documentation.

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 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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Vaccinations for Respiratory Infections

Measure Title

Adults ages 18-64 at high risk who ever received pneumococcal vaccination.

Measure Source

Healthy People 2010.

National Tables

8_1_4.1 Adults ages 18-64 at high risk who ever received a pneumococcal vaccination, United States, 2005-2008

8_1_4.2 Adults ages 18-64 at high risk who ever received a pneumococcal vaccination, United States, 1999-2004

8_1_4.3a-c Adults ages 18-64 at high risk who ever received a pneumococcal vaccination, United States, 2008, by:

• Race.
• Ethnicity.
• Family Income.

National Data Source

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

National Denominator

U.S. civilian noninstitutionalized population of adults ages 18-64 with a high risk condition.

National Numerator

The subset of the denominator who answered "yes" to the question: "Have you ever had a pneumonia vaccination, sometimes called a pneumonia shot? This shot is usually given only once in a person's lifetime and is different from the flu shot."

Comment

This measure is referred to as measure 14-29d in Healthy People 2010 documentation. and is one of the components of the Immunization Leading Health Indicators, which further defines the measure as pertaining to high-risk adults. See Appendix H of Tracking Healthy People 2010 for a complete listing of Leading Health Indicators.

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Vaccinations for Respiratory Infections

Measure Title

Adults age 65 and over who ever received pneumococcal vaccination.

Measure Source

Healthy People 2010.

National Tables

8_1_5.1 Adults age 65 and over who ever received a pneumococcal vaccination, United States, 2005-2008

8_1_5.2 Adults age 65 and over who ever received a pneumococcal vaccination, United States, 1999-2004

8_1_5.3a-c Adults age 65 and over who ever received a pneumococcal vaccination, United States, 2008, by:

• Race.
• Ethnicity.
• Family Income.

National Data Source

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

National Denominator

U.S. civilian noninstitutionalized population of adults age 65 and over.

National Numerator

The subset of the denominator who answered "yes" to the question "Have you ever had a pneumonia vaccination, sometimes called a pneumonia shot? This shot is usually given only once in a person's lifetime and is different from the flu shot."

State Table

8_1_5.4 Adults age 65 and over who ever received pneumococcal vaccination, by State, 2001-2008

State Data Source

CDC, Behavioral Risk Factor Surveillance System (BRFSS).

State Denominator

Number of adults age 65 and over.

State Numerator

Subset of the denominator who had a pneumonia vaccination.

Comments

State Tables are age adjusted to the 2000 standard population.

This measure is referred to as measure 14-29b in Healthy People 2010 documentation. and is one of the components of the Immunization Leading Health Indicators. See Appendix H of Tracking Healthy People 2010 for a complete listing of Leading Health Indicators.

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.

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Treatment of Respiratory Infections

Measure Title

Hospital patients with pneumonia who received recommended hospital care (blood cultures collected before antibiotics are administered, initial antibiotic dose within 6 hours of hospital arrival and consistent with current recommendations, and influenza and pneumococcal screening or vaccination).

Measure Source

Centers for Medicare & Medicaid Services (CMS), Health Care Quality Improvement Program Quality Indicator.

National Table

8_2_1.1 Hospital patients with pneumonia who received recommended hospital care, United States, 2007-2008

National Data Source

CMS, Quality Improvement Organization (QIO) Program.

National Denominator

Medicare hospital discharges age 65 and over meeting either of the following criteria: (1) principal diagnosis of pneumonia (ICD-9-CM codes: 480-483.8, 485-486, 487.0), or (2) secondary diagnosis of pneumonia and a principal diagnosis of either septicemia (ICD-9-CM code of 038.0-038.9) or respiratory failure (ICD-9-CM code 518.81).

National Numerator

Subset of the denominator who received recommended care, if indicated and appropriate, consisting of: blood cultures collected before antibiotics are administered, initial antibiotic dose within 6 hours of hospital arrival and consistent with current recommendations, and influenza and pneumococcal screening or vaccination.

State Table

8_2_1.2 Hospital patients with pneumonia who received recommended hospital care, by State, 2007-2008

State Data Source

CMS, QIO.

State Denominator

Same as National.

State Numerator

Same as National.

Comments

This is a composite measure. For State Tables, recommended hospital care for pneumonia includes having blood cultures collected before the administration of the first antibiotic dose, receiving the first dose of antibiotic within 6 hours of arrival at the hospital, receiving the recommended empirical antibiotic regimen that is consistent with current guidelines, screening for influenza vaccine status and vaccinating patients age 50 and over prior to discharge during the winter, and screening for pneumococcal vaccine status and vaccinating patients age 65 and over prior to discharge.

Further information about this and other pneumonia measures is available at http://www.cms.hhs.gov/HospitalQualityInits/.

Data were downloaded in late April each year from http://www.medicare.gov/Download/DownloadDB.asp. Estimates are calculated using hospital-level scores.

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Treatment of Respiratory Infections

Measure Title

Hospital patients with pneumonia who had blood cultures collected before antibiotics were administered.

Measure Source

Centers for Medicare & Medicaid Services (CMS), Health Care Quality Improvement Program Quality Indicator.

National Table

8_2_2.1 Hospital patients with pneumonia who had blood cultures collected before antibiotics were administered, United States, 2005-2008

National Data Source

CMS, Quality Improvement Organization (QIO) Program.

National Denominator

Discharged patients meeting either of the following criteria: (1) principal diagnosis of pneumonia (ICD-9-CM codes: 480-483.8, 485-486, 487.0), or (2) secondary diagnosis of pneumonia and a principal diagnosis of either septicemia (ICD-9-CM code of 038.0-038.9) or respiratory failure (acute or chronic, ICD-9-CM code 518.81) who had a blood culture performed during their inpatient stay.

National Numerator

Subset of the denominator population who had the blood culture performed prior to antibiotic administration.

State Table

8_2_2.2 Hospital patients with pneumonia who had blood cultures collected before antibiotics were administered, by State, 2005-2008

State Data Source

CMS, QIO.

State Denominator

Same as National.

State Numerator

Same as National.

Comments

Estimates are calculated using hospital-level scores.

Further information about this and other pneumonia measures is available at: http://www.cms.hhs.gov/HospitalQualityInits/.

For State Tables, data were downloaded in late April each year from: http://www.medicare.gov/Download/DownloadDB.asp.

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Treatment of Respiratory Infections

Measure Title

Hospital patients with pneumonia who received the initial antibiotic dose within 6 hours of arrival.

Measure Source

Centers for Medicare & Medicaid Services (CMS), Health Care Quality Improvement Program Quality Indicator.

National Table

8_2_3.1 Hospital patients with pneumonia who received the initial antibiotic dose within 6 hours of hospital arrival, United States, 2007 and 2008

National Data Source

CMS, Quality Improvement Organization (QIO) Program.

National Denominator

Discharged hospital patients meeting either of the following criteria: (1) principal diagnosis of pneumonia (ICD-9-CM codes: 480-483.8, 485-486, 487.0), or (2) secondary diagnosis of pneumonia and a principal diagnosis of either septicemia (ICD-9-CM code of 038.0-038.9) or respiratory failure (ICD-9-CM code 518.81).

National Numerator

Subset of the denominator who received their first dose of antibiotics within 6 hours after arrival at the hospital.

State Table

8_2_3.2 Hospital patients with pneumonia who received the initial antibiotic dose within 6 hours of hospital arrival, by State, 2007 and 2008

State Data Source

CMS, QIO.

State Denominator

Same as National.

State Numerator

Same as National.

Comments

Further information about this and other pneumonia measures is available at: http://www.cms.hhs.gov/HospitalQualityInits/.

For State Tables, data were downloaded in late April each year from: http://www.medicare.gov/Download/DownloadDB.asp.

Estimates are calculated using hospital-level scores.

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Treatment of Respiratory Infections

Measure Title

Hospital patients with pneumonia who received the initial antibiotic consistent with current recommendations.

Measure Source

Centers for Medicare & Medicaid Services (CMS), Health Care Quality Improvement Program Quality Indicator.

National Table

8_2_4.1 Hospital patients with pneumonia who received the initial antibiotic dose consistent with current recommendations, United States, 2005 -2008

National Data Source

CMS, Quality Improvement Organization (QIO) Program.

National Denominator

Discharged hospital patients meeting either of the following criteria: (1) principal diagnosis of pneumonia (ICD-9-CM codes: 480-483.8, 485-486, 487.0), or (2) secondary diagnosis of pneumonia and a principal diagnosis of either septicemia (ICD-9-CM code of 038.0-038.9) or respiratory failure (ICD-9-CM code 518.81).

National Numerator

Subset of the denominator who received an initial antibiotic regimen consistent with current guidelines during the first 24 hours of their hospitalization.

State Table

8_2_4.2 Hospital patients with pneumonia who received the initial antibiotic consistent with current recommendations, by State, 2005-2008

State Data Source

CMS, QIO.

State Denominator

Same as National.

State Numerator

Same as National.

Comments

Specification of the denominator of this measure has changed to exclude patients with healthcare-associated pneumonia. Reported rates may not be comparable to those reported in earlier years of the NHQR and NHDR.

Further information about this and other pneumonia measures is available at: http://www.cms.hhs.gov/HospitalQualityInits/.

For State Tables, data were downloaded in late April each year from: http://www.medicare.gov/Download/DownloadDB.asp.

Estimates are calculated using hospital-level scores.

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Treatment of Respiratory Infections

Measure Title

Hospital patients with pneumonia who received influenza screening or vaccination.

Measure Source

Centers for Medicare & Medicaid Services (CMS), Health Care Quality Improvement Program Quality Indicator.

National Table

8_2_5.1 Hospital patients age 50 and over with pneumonia discharge during October-February, who received an influenza screening or vaccination, United States, 2005-2008

National Data Source

CMS, Quality Improvement Organization (QIO) Program.

National Denominator

Medicare hospital discharges age 50 and over during October, November, December, January, and February meeting either of the following criteria: (1) principal diagnosis of pneumonia (ICD-9-CM codes: 480-483.8, 485-486, 487.0), or (2) secondary diagnosis of pneumonia and a principal diagnosis of either septicemia (ICD-9-CM code of 038.0-038.9) or respiratory failure (ICD-9-CM code 518.81).

National Numerator

Subset of the denominator who were screened for influenza vaccine status and were vaccinated prior to discharge, if indicated.

State Table

8_2_5.2 Hospital patients age 50 and over with pneumonia, discharged during October-February, who were screened for influenza vaccine status and were vaccinated prior to discharge, by State, 2005-2008

State Data Source

CMS, QIO.

CMS, Hospital Compare.

State Denominator

Same as National.

State Numerator

Same as National.

Comments

Further information about this and other pneumonia measures is available at: http://www.cms.hhs.gov/HospitalQualityInits/.

For State Tables, data were downloaded in late April each year, from: http://www.medicare.gov/Download/DownloadDB.asp.

Estimates are calculated using hospital-level scores.

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Treatment of Respiratory Infections

Measure Title

Hospital patients with pneumonia who received pneumococcal screening or vaccination.

Measure Source

Centers for Medicare & Medicaid Services (CMS), Health Care Quality Improvement Program Quality Indicator.

National Table

8_2_6.1 Hospital patients age 65 and over with pneumonia who received pneumococcal screening or vaccination, United States, 2005-2008

National Data Source

CMS, Quality Improvement Organization (QIO) Program.

National Denominator

Discharged hospital patients age 65 and over meeting either of the following criteria: (1) principal diagnosis of pneumonia (ICD-9-CM codes: 480-483.8, 485-486, 487.0), or (2) secondary diagnosis of pneumonia and a principal diagnosis of either septicemia (ICD-9-CM code of 038.0-038.9) or respiratory failure (ICD-9-CM code 518.81).

National Numerator

Subset of the denominator who were screened for pneumococcal vaccine status and were vaccinated prior to discharge, if indicated.

State Table

8_2_6.2 Hospital patients age 65 and over with pneumonia who received pneumococcal screening or vaccination, by State, 2005 -2008

State Data Source

CMS, QIO.

State Denominator

Same as National.

State Numerator

Same as National.

Comments

Further information about this and other pneumonia measures is available at: http://www.cms.hhs.gov/HospitalQualityInits/.

For State Tables, data were downloaded asp in late April each year from: http://www.medicare.gov/Download/DownloadDB.

Estimates are calculated using hospital-level scores.

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Treatment of Respiratory Infections

Measure Title

Deaths per 1,000 adult hospital admissions with pneumonia.

Measure Source

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

National Tables

8_2_7.1 Deaths per 1,000 hospital admissions with pneumonia as principal diagnosis, age 18 and over, United States, 2000, 2004-2007

8_2_7.2 Deaths per 1,000 admissions with pneumonia as principal diagnosis, age 18 and over, United States, 2007, by:

• Race/ethnicity.

National Data Source

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 Denominator

All discharges age 18 and over with principal diagnosis code of pneumonia (ICD-9-CM codes 003.22, 021.2, 039.1, 052.1, 055.1, 073.0, 112.4, 114.0, 114.4, 114.5, 115.05, 115.15, 115.95, 130.4, 136.3, 480.0-482.9), excluding patients transferring to another short-term hospital and obstetric admissions.

National Numerator

Subset of the denominator who died.

State Table

8_2_7.3 Deaths per 1,000 admissions with pneumonia as principal diagnosis, age 18 and over, by State, 2000, 2004-2007

State Data Source

AHRQ, CDOM, HCUP, State Inpatient Databases (SID).

State Denominator

Same as National.

State Numerator

Same as National.

Comments

Rates are adjusted by age, gender, age-gender interactions, and all patient refined-diagnosis related group risk of mortality score.

This table was created using version 3.1 of the AHRQ IQI software. This measure is referred to as IQI 20 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 NIS 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 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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Treatment of Respiratory Infections

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.

National Tables

8_2_8.1 Patients with tuberculosis who completed a curative course of treatment within 1 year of initiation of treatment, United States, 2000-2006

8_2_8.2a-d Patients with tuberculosis who completed a curative course of treatment within 1 year of initiation of treatment, United States, 2006, by:

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

National Data Source

CDC, National Tuberculosis Surveillance System (NTBSS).

National Denominator

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

National Numerator

Subset of the denominator completing therapy within 1 year.

Comments

For further information regarding current tuberculosis treatment guidelines, refer to: American Thoracic Society/Centers for Disease Control and Prevention/Infectious Diseases Society of America. Treatment of tuberculosis. Am J Respir Crit Care Med 2003;167:603-62.

For a discussion of completion of TB therapy, refer to Appendix A of the CDC publication Reported Tuberculosis in the United States, 2000. Available at: http://www.tbchicago.org/tbguidecdc/SURV/surv2000/pdfs/surv2000combined.pdf. [Plugin Software Help]

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

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Management of Asthma

Measure Title

People with current asthma who are now taking preventive medicine daily or almost daily (either oral or inhaler).

Measure Source

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

National Tables

8_3_1.1 People with current asthma who are now taking preventive medicine daily or almost daily, United States, 2003-2007

8_3_1.2a-d People with current asthma who are now taking preventive medicine daily or almost daily, United States, 2007, by:

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

National Data Source

AHRQ, CFACT, MEPS.

National Denominator

U.S. civilian noninstitutionalized population who currently have active asthma.

National Numerator

Subset of denominator who are taking daily or almost daily preventive medicine.

Comments

Preventive medicine may include oral or inhaler medications.

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Management of Asthma

Measure Title

People with asthma who were taking prescription medication to control asthma during the past 12 months.

Measure Source (National)

University of California, Los Angeles (UCLA), Center for Health Policy Research (CHPR), California Health Interview Survey (CHIS).

National Tables

8_3_1a-d People with asthma who were taking prescription medication to control asthma during the past 12 months, California, 2007, by:

• Race.
• Ethnicity.
• Income.
• Asian ethnicity.

National Data Source

UCLA, CHPR, CHIS.

National Denominator

California civilian noninstitutionalized population who had asthma or had an asthma attack during the past 12 months.

National Numerator

Subset of the denominator who reported taking prescription asthma control medication during the past 12 months.

Comments

A small number of people who were covered by both public and private health insurance plans were included in the "public health insurance" category only.

This measure is based on response QA07_B8 in the CHIS adult questionnaire "Are you now taking a daily medication to control your asthma that was prescribed or given to you by a doctor?"

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Management of Asthma

Measure Title

Hospital admissions for asthma per 100,000 population by age group.

Measure Source

Healthy People 2010.

Agency for Healthcare Research and Quality (AHRQ), Pediatric Quality Indicators (PDIs).

National Tables

8_3_2.1 Pediatric asthma admissions per 100,000 population, ages 2-17, United States, 2000, 2004-2007

8_3_2.2 Asthma admissions per 100,000 population, age 65 and over, United States, 2000, 2004-2007

8_3_2.3 Asthma admissions per 100,000 population, age 18 and over, United States, 2000, 2004-2007

8_3_2.4 Pediatric asthma admissions per 100,000 population, ages 2-17, United States, 2007, by:

• Race/ethnicity.

8_3_2.5 Asthma admissions per 100,000 population, age 65 and over, United States, 2007, by:

• Race/ethnicity.

8_3_2.6 Asthma admissions per 100,000 population, age 18 and over, United States, 2007, by:

• Race/ethnicity.

National Data Source

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 Denominator

As appropriate to each measure, the U.S. population of children ages 2-17 and adults age 18 and over or age 65 and over, excluding patients with cystic fibrosis or anomalies of the respiratory system and transfers from other institutions.

National Numerator

Subset of denominator with a principal hospital admission diagnosis of asthma (ICD-9-CM codes 493.00-493.92).

State Tables

8_3_2.7 Pediatric asthma admissions per 100,000 population, ages 2-17, by State, 2000, 2004-2007

8_3_2.8 Asthma admissions per 100,000 population, age 65 and over, by State, 2000, 2004-2007

8_3_2.9 Asthma admissions per 100,000 population, age 18 and over, by State, 2000, 2004-2007

State Data Source

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

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.

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

These tables were created using version 3.1 of the AHRQ PQI and PDI software. Pediatric measures are referred to as PDI 14 in the software documentation. Adult measures are referred to as PQI 15 in the software documentation. Adult measures include a modified version of PQI 15 as they exclude patients under age 65. More information about the AHRQ Quality Indicators is available at http://www.qualityindicators.ahrq.gov.

This measure is referred to as measure 24-2 in Healthy People 2010 documentation. The age range has been modified from the original specification. For age 65 and over, this measure is referred to as measure 24-2c in Healthy People 2010 documentation.

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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