Effectiveness of Care: Diabetes

2011 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.

Management of Diabetes
Composite measure: Adults age 40 and over with diagnosed diabetes who received all four recommended services for diabetes in the calendar year
Adults age 40 and over with diagnosed diabetes who received at least two hemoglobin A1c tests in the calendar year
Adults age 40 and over with diagnosed diabetes who received a dilated eye examination in the calendar year
Adults age 40 and over with diagnosed diabetes who had their feet checked for sores or irritation in the calendar year
Adults age 40 and over with diagnosed diabetes who received an influenza vaccination
Adults age 40 and over with diabetes whose condition was diagnosed
Incidence of end stage renal disease (ESRD) due to diabetes

Control of Diabetes
Adults age 40 and over with diagnosed diabetes with an HbA1c level under optimal control
Adults age 40 and over with diagnosed diabetes who have a total cholesterol level less than or equal to 200 mg/dL
Adults age 40 and over with diagnosed diabetes with blood pressure less than 140/80 mm Hg

Hospitalizations for Diabetes
Hospital admissions for uncontrolled diabetes among adults
Hospital admissions for short-term complications of diabetes
Hospital admissions for long-term complications of diabetes
Hospital discharges for lower extremity amputations per 1,000 population age 18 and over with diabetes


 

Management of Diabetes

Measure Title

Composite measure: Adults age 40 and over with diagnosed diabetes who received all four recommended services for diabetes in the calendar year.

Measure Source

National Diabetes Quality Improvement Alliance.

National Tables

4_1_1.1 Adults age 40 and over with diagnosed diabetes who received all four recommended services for diabetes in the calendar year, United States, 2008

4_1_1.2a-d Adults age 40 and over with diagnosed diabetes who received all four recommended services for diabetes in the calendar year, United States, 2008, by:

  1. Race.
  2. Ethnicity.
  3. Family income.
  4. Education.

National Data Source

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

National Denominator

U.S. civilian noninstitutionalized population age 40 and over with diabetes and a positive Diabetes Care Survey weight. Cases with missing values were excluded.

National Numerator

Subset of the denominator who responded "Yes" to each of the four survey items related to receipt of diabetes services.

Comments

The criteria for selecting the diabetes population from MEPS and the methodology for calculating the diabetes composite measure have changed over time. Reported rates may not be comparable with those found in prior years' editions of the NHQR and NHDR. The composite measure for this year's edition of the reports, for example, contains four measures (two or more hemoglobin A1c measurements, dilated eye examination, foot examination, and flu shot within the calendar year), whereas the composite measure for the 2010 reports contained three measures (at least one hemoglobin A1c measurement, dilated eye examination, and foot examination within the calendar year).

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 NHQR and NHDR; rates may not be comparable with those reported in earlier editions.

Cases with any missing values for the measures that make up the composite were excluded from the analysis.

The entries for each of the four components of the composite measure provide further details about the individual survey questions.

Top of Page


 

Management of Diabetes

Measure Title

Adults age 40 and over with diagnosed diabetes who received at least two hemoglobin A1c tests in the calendar year.

Measure Source

Healthy People 2020.

National Tables

4_1_2.1 Adults age 40 and over with diagnosed diabetes who received two or more hemoglobin A1c measurements in the calendar year, United States, 2002-2008

4_1_2.2a-d Adults age 40 and over with diagnosed diabetes who received two or more hemoglobin A1c measurements in the calendar year, United States, 2008, by:

  1. Race.
  2. Ethnicity.
  3. Family income.
  4. Education.

National Data Source

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

National Denominator

U.S. civilian noninstitutionalized population age 40 and over with diabetes who had a positive Diabetes Care Survey (DCS) weight and who responded to the DCS question: "How many times did a doctor, nurse, or other health professional check for glycosylated hemoglobin or �hemoglobin A-one-C'?" Nonrespondents and "Don't Know" responses were excluded.

National Numerator

Subset of the denominator who had a positive DCS weight and who had a hemoglobin A1c test at least twice in the last calendar year.

State Table

4_1_2.3 Adults age 40 and over with diagnosed diabetes who received two or more hemoglobin A1c measurements in the year, by State, United States, 2001-2009

State Data Source

Centers for Disease Control and Prevention (CDC), Behavioral Risk Factor Surveillance System (BRFSS).

State Denominator

Adults age 40 and over with diabetes.

State Numerator

Subset of denominator who had a hemoglobin A1c test at least twice in the survey year.

Comments

The criteria for selecting the diabetes population from MEPS have changed; reported national rates may not be comparable with those found in prior years' editions of the NHQR and NHDR.

The national table reports data from the MEPS DCS. The MEPS entry in the Data Sources appendix and http://www.meps.ahrq.gov/ provide more information on the DCS and MEPS panels. Estimates are age adjusted to the 2000 U.S. standard population with two age-groups: 40-59 and 60 and over.

This measure is referred to as measure D-11 in Healthy People 2020 documentation.

Top of Page


 

Management of Diabetes

Measure Title

Adults age 40 and over with diagnosed diabetes who received a dilated eye examination in the calendar year.

Measure Source

Healthy People 2020.

National Tables

4_1_3.1 Adults age 40 and over with diagnosed diabetes who received a dilated eye examination in the calendar year, United States, 2002-2008

4_1_3.2a-d Adults age 40 and over with diagnosed diabetes who received a dilated eye examination in the calendar year, United States, 2008, by:

  1. Race.
  2. Ethnicity.
  3. Family income.
  4. Education.

National Data Source

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

National Denominator

U.S. civilian noninstitutionalized population age 40 and over with diabetes who responded to the Diabetes Care Survey (DCS) question: "When was the last time you had an eye exam in which the pupils were dilated? This would have made you temporarily sensitive to light."

National Numerator

Subset of denominator who indicated they had at least one retinal eye examination in the calendar year.

State Table

4_1_3.3 Adults age 40 and over with diagnosed diabetes who received a dilated eye examination in the calendar year, by State, United States, 2001-2009.

State Data Source

Centers for Disease Control and Prevention (CDC), Behavioral Risk Factor Surveillance System (BRFSS).

State Denominator

Adults age 40 and over with diabetes.

State Numerator

Adults with diabetes who had at least one retinal eye examination in the survey year.

Comments

The criteria for selecting the diabetes population from MEPS have changed; reported national rates may not be comparable with those found in prior years' editions of the NHQR and NHDR.

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

The national table reports data from the MEPS Diabetes Care Survey (DCS). The MEPS entry in the Data Sources appendix and http://www.meps.ahrq.gov/ provide more information on the DCS and MEPS panels.

Nonrespondents and "Don't Know" responses to the DCS question were excluded from the analysis. Estimates are age adjusted to the 2000 U.S. standard population with two age groups: 40-59 and 60 and over.

This measure is referred to as measure D-10 in Healthy People 2020 documentation.

Top of Page


 

Management of Diabetes

Measure Title

Adults age 40 and over with diagnosed diabetes who had their feet checked for sores or irritation in the calendar year.

Measure Source

Healthy People 2020.

National Tables

4_1_4.1 Adults age 40 and over with diagnosed diabetes who had their feet checked for sores or irritation in the calendar year, United States, 2002-2008

4_1_4.2a-d Adults age 40 and over with diagnosed diabetes that had their feet checked for sores or irritation in the calendar year, United States, 2008, by:

  1. Race.
  2. Ethnicity.
  3. Family income.
  4. Education.

National Data Source

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

National Denominator

U.S. civilian noninstitutionalized population age 40 and over with diabetes who responded to the question: "Hhow many times did a health professional check your feet for any sores or irritations?" Nonrespondents and "Don't Know" responses were excluded.

National Numerator

Subset of denominator who had a foot examination one or more times in the calendar year.

State Table

4_1_4.3 Adults age 40 and over with diagnosed diabetes who had their feet checked for sores or irritation in the calendar year, by State, United States, 2001-2009

State Data Source

Centers for Disease Control and Prevention (CDC), Behavioral Risk Factor Surveillance System (BRFSS).

State Denominator

Adults age 40 and over with diabetes.

State Numerator

Subset of denominator who had one or more foot examinations in the survey year.

Comments

The criteria for selecting the diabetes population from MEPS have changed; reported national rates may not be comparable with those found in prior years' editions of the NHQR and NHDR.

The national table reports data from the MEPS Diabetes Care Survey (DCS). The MEPS entry in the Data Sources appendix and http://www.meps.ahrq.gov/ provide more information on the DCS and MEPS panels.

Estimates are age adjusted to the 2000 U.S. standard population with two age groups: 40-59 and 60 and over.

This measure is referred to as measure D-9 in Healthy People 2020 documentation.

Top of Page


 

Management of Diabetes

Measure Title

Adults age 40 and over with diagnosed diabetes who received an influenza vaccination.

Measure Source

National Diabetes Quality Improvement Alliance, National Quality Forum.

National Tables

4_1_5.1 Adults age 40 and over with diagnosed diabetes who received a flu shot in the last 12 months, United States, 2008

4_1_5.2a-d Adults age 40 and over with diagnosed diabetes who received a flu shot in the last 12 months, United States, 2008, by:

  1. Race.
  2. Ethnicity.
  3. Family income.
  4. Education.

National Data Source

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

National Denominator

U.S. civilian noninstitutionalized adults age 40 and over with diabetes who responded to the question: "How long since you had a flu shot?" Nonrespondents and "Don't Know" responses were excluded.

National Numerator

Subset of the denominator who had an influenza immunization in the past year.

State Table

4_1_5.3 Adults age 40 and over with diagnosed diabetes who received an influenza vaccination in the last 12 months, by State, United States, 2009.

State Data Source

Centers for Disease Control and Prevention (CDC), Behavioral Risk Factor Surveillance System (BRFSS).

State Denominator

Adults age 40 and over with diabetes.

State Numerator

Subset of the denominator who had an influenza immunization in the survey year.

Comments

The criteria for selecting the diabetes population from MEPS have changed; reported national rates may not be comparable with those found in prior years' editions of the NHQR and NHDR.

The MEPS entry in the Data Sources appendix and http://www.meps.ahrq.gov/ provide more information on the DCS and MEPS panels.

Top of Page


 

Management of Diabetes

Measure Title

Adults age 40 and over with diabetes whose condition was diagnosed.

Measure Source

Healthy People 2020.

National Table

4_1_6.1 Adults age 40 and over with diabetes whose condition was diagnosed, United States, 2001-2004 and 2005-2008

National Data Source

Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS), National Health and Nutrition Examination Survey (NHANES).

National Denominator

Adults age 40 and over who have physician-diagnosed or undiagnosed diabetes (fasting blood glucose level ≥126 mg/dL).

National Numerator

Subset of denominator who report that they have ever been diagnosed with diabetes.

Comments

This measure is referred to as measure D-15 in Healthy People 2020 documentation. Estimates are age adjusted to the 2000 U.S. standard population using two age groups: 40-59 and 60 and over, except where indicated.

Women who reported having diabetes only during pregnancy (gestational diabetes) are excluded.

Top of Page


 

Management of Diabetes

Measure Title

Incidence of end stage renal disease (ESRD) due to diabetes.

Measure Source

National Institutes of Health (NIH), National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), United States Renal Data System (USRDS).

National Table

4_1_7.1 Adjusted incident rates of end stage renal disease due to diabetes per million population, United States, 2000-2008

National Data Source

NIH, NIDDK, USRDS.

National Denominator

U.S. civilian noninstitutionalized population.

National Numerator

Subset of denominator with ESRD due to diabetes.

Top of Page


 

Control of Diabetes

Measure Title

Adults age 40 and over with diagnosed diabetes with an HbA1c level under optimal control.

Measure Source

Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS), National Health and Nutrition Examination Survey (NHANES).

National Tables

4_2_1.1 Adults age 40 and over with diagnosed diabetes with HbA1c level less than 7.0% (optimal control), United States, 2001-2004 and 2005-2008

National Data Source

CDC, NCHS, NHANES.

Denominator

Adults age 40 and over with diabetes.

Numerator

Subset of the denominator who had hemoglobin A1c level less than 7.0% at examination.

Comments

The criteria for selecting the diabetes population from NHANES have changed; reported rates may not be comparable with those found in prior years' editions of the NHQR and NHDR.

Estimates are age adjusted to the 2000 U.S. standard population using two age groups: 40-59 and 60 and over,

Optimal control is defined as having an HbA1c less than 7%.

Top of Page


Control of Diabetes

Measure Title

Adults age 40 and over with diagnosed diabetes who have a total cholesterol level less than or equal to 200 mg/dL.

Measure Source

National Diabetes Quality Improvement Alliance, National Quality Forum.

National Table

4_2_2.1 Adults age 40 and over with diagnosed diabetes with total cholesterol less than 200 mg/dL, United States, 2001-2004 and 2005-2008

National Data Source

Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS), National Health and Nutrition Examination Survey (NHANES).

Denominator

Adults age 40 and over with diabetes.

Numerator

Subset of the denominator with most recent total cholesterol level less than 200 mg/dL at examination.

Comments

The criteria for selecting the diabetes population from NHANES have changed; reported rates may not be comparable with those found in prior years' editions of the NHQR and NHDR.

Estimates are age adjusted to the 2000 U.S. standard population using two age groups: 40-59 and 60 and over,

Top of Page


Control of Diabetes

Measure Title

Adults age 40 and over with diagnosed diabetes with blood pressure less than 140/80 mm Hg.

Measure Source

National Alliance for Diabetes Quality Improvement, National Quality Forum.

Tables

4_2_3.1 Adults age 40 and over with diagnosed diabetes with systolic blood pressure less than 140 mm Hg and diastolic blood pressure less than 80 mm Hg based on average blood pressure measurements, United States, 2001-2004 and 2005-2008

National Data Source

Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS), National Health and Nutrition Examination Survey (NHANES).

Denominator

Adults age 40 and over with diagnosed diabetes.

Numerator

Subset of denominator who have blood pressure less than 140/80 mm/Hg at examination.

Comments

The criteria for selecting the diabetes population from NHANES have changed; reported rates may not be comparable with those found in prior years' editions of the NHQR and NHDR.

Estimates are age adjusted to the 2000 U.S. standard population using two age groups: 40-59 and 60 and over.

Top of Page


 

Hospitalizations for Diabetes

Measure Title

Hospital admissions for uncontrolled diabetes among adults.

Measure Source

Agency for Healthcare Research and Quality (AHRQ), Center for Delivery, Organization, and Markets (CDOM), Healthcare Cost and Utilization Project (HCUP), Prevention Quality Indicators (PQIs).

National Tables

4_3_1.1_1 Admissions for uncontrolled diabetes without complications per 100,000 population, age 18 and over, United States, 2000, 2004, 2005, 2007, and 2008

4_3_1.1_2 Admissions for uncontrolled diabetes without complications per 100,000 population, age 18 and over, by race/ethnicity, United States, 2008

4_3_1.2_1 Hospital admissions for uncontrolled diabetes per 100,000 population age 18 and over in Indian Health Service, Tribal direct, and contract hospitals and community hospitals, United States, 2000-2009

4_3_1.1_4 Admissions for uncontrolled diabetes without complications per 100,000 population, age 18 and over, by income, United States, 2000-2008

National Data Source

AHRQ, CDOM, HCUP Nationwide Inpatient Sample (NIS) and AHRQ Quality Indicators, modified version 4.1.

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

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

National Denominator

U.S. population in metropolitan area or county, age 18 years and over.

IHS service population, age 18 years and over. Service population does not include the Portland and California regions.

National Numerator

Subset of denominator with discharges with a principal diagnosis of uncontrolled diabetes and without mention of short-term or long-term complications.

State Table

4_3_1.1_3 Admissions for uncontrolled diabetes without complications per 100,000 population, age 18 and over, by State, United States, 2000, 2004, 2007, and 2008

State Data Source

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

State Denominator

Same as national.

State Numerator

Same as national.

Comments

Short-term complications include ketoacidosis, hyperosmolarity, and coma. Long-term complications include renal, eye, neurologic, circulatory, and other unspecified. Excludes obstetric admissions and transfers from other institutions.

Rates are adjusted by age and gender using the total U.S. resident population for 2000 as the standard population; when reporting is by age, the adjustment is by gender only; when reporting is by gender, the adjustment is by age only.

Although not all States participate in the HCUP database, 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.

SID includes a powerful set of hospital databases from data organizations in participating States. SID contains the universe of the inpatient discharge abstracts in participating States, translated into a uniform format to facilitate multi-State comparisons and analyses. Together, SID encompasses about 90% of all U.S. community hospital discharges. SID contains a core set of clinical and nonclinical information on all patients, regardless of payer, including people covered by Medicare, Medicaid, and private insurance, as well as uninsured people. In addition to the core set of uniform data elements common to all SID, some databases within SID include other elements, such as the patient's race.

The SID disparities analysis file is designed to provide national estimates on disparities using weighted records from a sample of hospitals from the following 31 States: Arizona, Arkansas, California, Colorado, Connecticut, Florida, Georgia, Hawaii, Kansas, Kentucky, Maine, Maryland, Massachusetts, Michigan, Missouri, Nevada, New Hampshire, New Jersey, New York, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Utah, Virginia, Vermont, Wisconsin, and Wyoming.

Top of Page


Hospitalizations for Diabetes

Measure Title

Hospital admissions for short-term complications of diabetes.

Measure Source

Agency for Healthcare Research and Quality (AHRQ), Center for Delivery, Organization, and Markets (CDOM), Healthcare Cost and Utilization Project (HCUP), Prevention Quality Indicators (PQIs) and Pediatric Quality Indicators (PDIs).

National Tables

4_3_1.2_1 Hospital admissions for uncontrolled diabetes per 100,000 population age 18 and over in Indian Health Service, Tribal direct, and contract hospitals and community hospitals, United States, 2000-2009

4_3_2.1_1 Admissions for diabetes with short-term complications per 100,000 population, age 18 and over, United States, 2000, 2004, 2005, 2007, and 2008.

4_3_2.1_2 Admissions for diabetes with short-term complications per 100,000 population, age 18 and over, by race/ethnicity, United States, 2008

4_3_2.1_4 Admissions for diabetes with short-term complications per 100,000 population, age 18 and over, by income, United States, 2000-2008

4_3_2.2_1 Admissions for diabetes with short-term complications per 100,000 population, ages 6-17, United States, 2000, 2004, 2005, 2007, and 2008

4_3_2.2_2 Admissions for diabetes with short-term complications per 100,000 population, ages 6-17, by race/ethnicity, United States, 2008

4_3_2.2_4 Admissions for diabetes with short-term complications per 100,000 population, ages 6-17, by income, United States, 2000-2008

4_3_2.3_1 Hospital admissions for short term complications of diabetes per 100,000 population age 18 and over in Indian Health Service, Tribal direct, and contract hospitals and community hospitals, 2000-2009

National Data Source

AHRQ, CDOM, HCUP, Nationwide Inpatient Sample (NIS) and AHRQ Quality Indicators, modified version 4.1.

National Denominator

U.S. population ages 6-17 (for pediatric measure) or age 18 and over (for adult measure) by subcategories.

National Numerator

Pediatric discharges ages 6-17 or adult discharges age 18 and over with a principal diagnosis of diabetes with short-term complications. Consistent with the AHRQ PQI software, diabetes must be the principal diagnosis and short-term complications include ketoacidosis, hyperosmolarity, or coma. Transfers from other institutions are excluded.

State Tables

4_3_2.1_3 Admissions for diabetes with short-term complications per 100,000 population, age 18 and over, by State, United States, 2000, 2004, 2007, and 2008

4_3_2.2_3 Admissions for diabetes with short-term complications per 100,000 population, ages 6-17, by State, United States, 2000, 2004, 2007, and 2008

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 and gender using the total U.S. resident population for 2000 as the standard population; when reporting is by age, the adjustment is by gender only; when reporting is by gender, the adjustment is by age only.

Although not all States participate in the HCUP database, 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.

SID includes a powerful set of hospital databases from data organizations in participating States. SID contains the universe of the inpatient discharge abstracts in participating States, translated into a uniform format to facilitate multi-State comparisons and analyses. Together, SID encompasses about 90% of all U.S. community hospital discharges. SID contains a core set of clinical and nonclinical information on all patients, regardless of payer, including people covered by Medicare, Medicaid, and private insurance, as well as uninsured people. In addition to the core set of uniform data elements common to all SID, some databases within SID include other elements, such as the patient's race.

The SID disparities analysis file is designed to provide national estimates on disparities using weighted records from a sample of hospitals from the following 31 States: Arizona, Arkansas, California, Colorado, Connecticut, Florida, Georgia, Hawaii, Kansas, Kentucky, Maine, Maryland, Massachusetts, Michigan, Missouri, Nevada, New Hampshire, New Jersey, New York, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Utah, Virginia, Vermont, Wisconsin, and Wyoming.

Top of Page


Hospitalizations for Diabetes

Measure Title

Hospital admissions for long-term complications of diabetes.

Measure Source

Agency for Healthcare Research and Quality (AHRQ), Center for Delivery, Organization, and Markets (CDOM), Healthcare Cost and Utilization Project (HCUP), Prevention Quality Indicators (PQIs).

National Tables

4_3_3.1 Admissions for diabetes with long-term complications per 100,000 population, age 18 and over, United States, 2000, 2004, 2005, 2007, and 2008

4_3_3.2 Admissions for diabetes with long-term complications per 100,000 population, age 18 and over, by race/ethnicity, United States, 2008

4_3_3.4 Admissions with diabetes with long-term complications per 100,000 population, age 18 and over, by income, United States, 2000-2008

National Data Source

AHRQ, CDOM, HCUP, Nationwide Inpatient Sample (NIS) and AHRQ Quality Indicators, modified version 4.1.

National Denominator

U.S. population age 18 and over.

National Numerator

Subset of the denominator with hospital inpatient discharges with a principal diagnosis code for diabetes with long-term complications. Consistent with the AHRQ PQI software, diabetes must be the principal diagnosis and long-term complications include renal, eye, neurologic, circulatory, or other unspecified complications. Transfers from other institutions and obstetric admissions are excluded.

State Table

4_3_3.3 Admissions with diabetes with long-term complications per 100,000 population, age 18 and over, by State, United States, 2000, 2004, 2007, and 2008

State Data Source

AHRQ, CDOM, HCUP, Statewide 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. resident population for 2000 as the standard population; when reporting is by age, the adjustment is by gender only; when reporting is by gender, the adjustment is by age only.

Although not all States participate in the HCUP database, 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.

SID includes a powerful set of hospital databases from data organizations in participating States. SID contains the universe of the inpatient discharge abstracts in participating States, translated into a uniform format to facilitate multi-State comparisons and analyses. Together, SID encompasses about 90% of all U.S. community hospital discharges. SID contains a core set of clinical and nonclinical information on all patients, regardless of payer, including people covered by Medicare, Medicaid, and private insurance, as well as uninsured people. In addition to the core set of uniform data elements common to all SID, some databases within SID include other elements, such as the patient's race.

The SID disparities analysis file is designed to provide national estimates on disparities using weighted records from a sample of hospitals from the following 31 States: Arizona, Arkansas, California, Colorado, Connecticut, Florida, Georgia, Hawaii, Kansas, Kentucky, Maine, Maryland, Massachusetts, Michigan, Missouri, Nevada, New Hampshire, New Jersey, New York, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Utah, Virginia, Vermont, Wisconsin, and Wyoming.

Top of Page


Hospitalizations for Diabetes

Measure Title

Hospital admissions for lower extremity amputations per 1,000 population age 18 and over with diabetes.

Measure Source

Healthy People 2020.

National Tables

4_3_4.1 Hospital admissions for lower extremity amputations per 1,000 population with diabetes, United States, 2000-2007

4_3_4.2 Hospital admissions for lower extremity amputations per 1,000 population with diabetes, by race, United States, 2005-2007

National Data Source

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

National Denominator

U.S. civilian noninstitutionalized population who report that they have ever been diagnosed with diabetes, excluding women age 18 and over who report that the only time they have been diagnosed with diabetes was during pregnancy (gestational diabetes).

National Numerator

Subset of the denominator with amputation of a lower extremity as any listed procedure upon discharge. Amputations due to trauma are excluded.

Comments

Estimates are age adjusted to the 2000 U.S. standard population using three age groups: 0-64, 65-74, and 75 and over, except where indicated. This measure is referred to as measure D-4 in Healthy People 2020 documentation.

Top of Page

Current as of March 2012
Internet Citation: Effectiveness of Care: Diabetes: 2011 National Healthcare Quality and Disparities Reports. March 2012. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/research/findings/nhqrdr/nhqrdr11/measurespec/diabetes.html