Timeliness

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.

 

Getting Appointments for Care
Adults who had an appointment for routine health care in the last 12 months who sometimes or never got appointments for routine care as soon as wanted
Adults with Medicare or Medicaid who had an appointment for routine health care in the last 12 months who sometimes or never got appointments for routine care as soon as wanted
Children who had an appointment for routine health care in the last 12 months who sometimes or never got appointments for routine care as soon as wanted
Children who had an appointment for routine health care in the last 6 months who sometimes or never got appointments for routine care as soon as wanted
Adults who needed care right away for an illness, injury, or condition in the last 12 months who sometimes or never got care as soon as wanted
Adults with Medicare or Medicaid who needed care right away for an illness, injury, or condition who sometimes or never got care as soon as wanted
Children who needed care right away for an illness, injury, or condition in the last 12 months who sometimes or never got care as soon as wanted
Children with Medicaid who needed care right away for an illness, injury, or condition who sometimes or never got care as soon as wanted

Waiting Time
Emergency department (ED) visits in which patient had to wait an hour or more by urgency
Hospital patients with heart attack who received percutaneous coronary intervention (PCI) within 90 minutes of arrival
Hospital patients with heart attack who received fibrinolytic medication within 30 minutes of arrival
 


 

Getting Appointments for Care

Measure Title

Adults who had an appointment for routine health care in the last 12 months who sometimes or never got appointments for routine care as soon as wanted.

Measure Source

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

National Tables

13_1_1.1 Adults who made an appointment for routine health care in the last 12 months who sometimes or never got an appointment as soon as wanted, United States, 2002-2008

13_1_1.2a-d Adults who made an appointment for routine health care in the last 12 months who sometimes or never got an appointment as soon as wanted, United States, 2008 by:

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

National Data Source

AHRQ, CFACT, MEPS.

National Denominator

Adults age 18 and over who made an appointment for regular or routine health care in the past 12 months and had a valid response to the MEPS question, "In the last 12 months, how often did you get an appointment for regular or routine health care as soon as you wanted?"

National Numerator

Subset of the denominator who answered "Sometimes" or "Never."

Comments

National tables report data from the MEPS Self-Administered Questionnaire (SAQ). The MEPS entry in the Data Sources appendix has more information on the SAQ.

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Getting Appointments for Care

Measure Title

Adults with Medicare or Medicaid who had an appointment for routine health care who sometimes or never got appointments for routine care as soon as wanted.

Measure Source

Agency for Healthcare Research and Quality (AHRQ), Center for Quality Improvement and Patient Safety (CQuIPS), National CAHPS® (Consumer Assessment of Healthcare Providers and Systems) Benchmarking Database.

State Tables

13_1_1.3_1 Adults who had an appointment for routine health care in the last 6 months who sometimes or never got appointments for routine care as soon as wanted, Medicaid, by State, 2010

13_1_1.4_1 Adults who had an appointment for routine health care in the last 12 months who sometimes or never got appointments for routine care as soon as wanted, Medicare managed care, by State, 2010

13_1_1.5_1 Adults who had an appointment for routine health care in the last 12 months who sometimes or never got appointments for routine care as soon as wanted, Medicare fee for service, by State, 2010

13_1_1.6_1 Adults who had an appointment for routine health care in the last 12 months who sometimes or never got appointments for routine care as soon as wanted, commercial plans, by State, 2010

State Data Source

AHRQ, CQuIPS, CAHPS.

State Denominator

For Medicaid, respondents who answered "Yes" to the question, "In the last 6 months did you make any appointments with a doctor or other health care provider for regular or routine health care?"

For Medicare managed care and Medicare fee for service, respondents who answered "Yes" to the question, "In the last 12 months did you make any appointments with a doctor or other health care provider for regular or routine health care?"

State Numerator

For Medicaid, subset of the denominator population who answered "Sometimes" or "Never" to the question, "In the last 6 months, not counting times you needed health care right away, how often did you get an appointment for health care as soon as you wanted?"

For Medicare managed care and Medicare fee for service, subset of the denominator population who answered "Sometimes" or "Never" to the question, "In the last 12 months, not counting times you needed health care right away, how often did you get an appointment for health care as soon as you wanted?"

Comments

CAHPS surveys ask consumers and patients to report on and evaluate their experiences with health care. These surveys cover topics that are important to consumers and focus on aspects of quality that consumers are best qualified to assess, such as the communication skills of providers and ease of access to health care services.

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Getting Appointments for Care

Measure Title

Children who had an appointment for routine health care in the last 12 months who sometimes or never got appointments for routine care as soon as wanted.

Measure Source

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

National Tables

13_1_2.1 Children who had an appointment for routine health care in the last 12 months who sometimes or never got an appointment as soon as wanted, United States, 2002-2008

13_1_2.2a-c Children who had an appointment for routine health care in the last 12 months who sometimes or never got an appointment for routine care as soon as wanted, United States, 2008 by:

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

National Data Source

AHRQ, CFACT, MEPS.

National Denominator

Children who had an appointment for regular or routine health care in the past 12 months and with a valid response to the question "In the last 12 months, how often did [the person] get an appointment for regular or routine health care as soon as you wanted?" Nonresponses and "Don't Know" responses were excluded.

National Numerator

Subset of the denominator who, according to their parents or guardians, answered the above question "Sometimes" or "Never."

Comments

The national table reports data from the MEPS Child Health section. The MEPS entry in the Data Sources appendix has more information. Nonrespondents and "Don't Know" responses were excluded.

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Getting Appointments for Care

Measure Title

Children who had an appointment for routine health care in the last 6 months who sometimes or never got appointments for routine care as soon as wanted.

Measure Source

Agency for Healthcare Research and Quality (AHRQ), Center for Quality Improvement and Patient Safety (CQuIPS), National CAHPS® (Consumer Assessment of Healthcare Providers and Systems) Benchmarking Database.

State Table

13_1_2.3�_1 Children who had an appointment for routine health care in the last 6 months who sometimes or never got appointments for routine care as soon as wanted, Medicaid, by State, United States, 2010

State Data Source

AHRQ, CQuIPS, CAHPS.

State Denominator

Children with Medicaid benefits who had appointments with a doctor or other health care provider for regular or routine health care in the last 6 months.

State Numerator

Subset of the denominator population with their parent or guardian's answer of "Sometimes" or "Never" to the question, "In the last 6 months, not counting times you needed health care right away, how often did you get an appointment for health care as soon as you wanted?"

Comments

CAHPS surveys ask consumers and patients to report on and evaluate their experiences with health care. These surveys cover topics that are important to consumers and focus on aspects of quality that consumers are best qualified to assess, such as the communication skills of providers and ease of access to health care services.

Top of Page


 

Getting Appointments for Care

Measure Title

Adults who needed care right away for an illness, injury, or condition in the last 12 months who sometimes or never got care as soon as wanted.

Measure Source

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

National Tables

13_1_3.1 Adults who needed care right away for an illness, injury, or condition in the last 12 months who sometimes or never got care as soon as wanted, United States, 2002-2008

13_1_3.2a-d Adults who needed care right away for an illness, injury, or condition in the last 12 months who sometimes or never got care as soon as wanted, United States, 2007, by:

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

National Data Source

AHRQ, CFACT, MEPS.

National Denominator

Adults age 18 and over who in the past 12 months had an illness or injury who needed care right away and had a valid response to the question, "In the last 12 months, when you needed care right away for an illness or injury, how often did you get care as soon as you wanted?"

National Numerator

Subset of the denominator who responded "Sometimes" or "Never" to the above question.

Comments

Nonrespondents and "Don't Know" responses were excluded.

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Getting Appointments for Care

Measure Title

Adults with Medicare or Medicaid who needed care right away for an illness, injury, or condition who sometimes or never got care as soon as wanted.

Measure Source

Agency for Healthcare Research and Quality (AHRQ), Center for Quality Improvement and Patient Safety (CQuIPS), National CAHPS® (Consumer Assessment of Healthcare Providers and Systems) Benchmarking Database.

State Tables

13_1_3.3_1 Adults who needed care right away for an illness, injury, or condition in the last 6 months who sometimes or never got care as soon as wanted, Medicaid, by State, United States, 2010

13_1_3.4_1 Adults who needed care right away for an illness, injury, or condition in the last 12 months who sometimes or never got care as soon as wanted, Medicare managed care, by State, United States, 2010

13_1_3.5_1 Adults who needed care right away for an illness, injury, or condition in the last 12 months who sometimes or never got care as soon as wanted, Medicare fee-for-service, by State, United States, 2010

13_1_3.6_1 Adults who needed care right away for an illness, injury, or condition in the last 12 months who sometimes or never got care as soon as wanted, commercial plans, by State, United States 2010

State Data Source

AHRQ, CQuIPS, CAHPS.

State Denominator

For Medicaid, adults who reported having an illness, injury, or condition that needed care right away in a clinic, emergency room, or doctor's office in the last 6 months.

For Medicare managed care and Medicare fee for service, adults who reported having an illness, injury, or condition that needed care right away in a clinic, emergency room, or doctor's office in the last 12 months.

State Numerator

For Medicaid, subset of the denominator who answered "Sometimes" or "Never" to the question, "In the last 6 months, when you needed care right away for an illness, injury, or condition, how often did you get care as soon as you wanted?"

For Medicare managed care and Medicare fee for service, subset of the denominator who answered "Sometimes" or "Never" to the question, "In the last 12 months, when you needed care right away for an illness, injury, or condition, how often did you get care as soon as you wanted?"

Comments

CAHPS surveys ask consumers and patients to report on and evaluate their experiences with health care. These surveys cover topics that are important to consumers and focus on aspects of quality that consumers are best qualified to assess, such as the communication skills of providers and ease of access to health care services.

Top of Page


 

Getting Appointments for Care

Measure Title

Children who needed care right away for an illness, injury, or condition in the last 12 months who sometimes or never got care as soon as wanted.

Measure Source

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

National Tables

13_1_4.1 Children who needed care right away for an illness, injury, or condition in the last 12 months who sometimes or never got care as soon as wanted, United States, 2002-2008

13_1_4.2a-c Children who needed care right away for an illness, injury, or condition in the last 12 months who sometimes or never got care as soon as wanted, United States, 2008, by:

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

National Data Source

AHRQ, CFACT, MEPS.

National Denominator

Children under age 18 who had an illness or injury that needed care right away in the past 12 months with a valid response to the question, "In the last 12 months, when [the person] needed care right away for an illness or injury, how often did [person] get care as soon as you wanted?"

National Numerator

Subset of the denominator whose parents or guardians' answered the above question "Sometimes" or "Never."

Comments

Nonrespondents and respondents indicating "Don't Know" were excluded.

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Getting Appointments for Care

Measure Title

Children with Medicaid who needed care right away for an illness, injury, or condition who sometimes or never got care as soon as wanted.

Measure Source

Agency for Healthcare Research and Quality (AHRQ), Center for Quality Improvement and Patient Safety (CQuIPS), National CAHPS® (Consumer Assessment of Healthcare Providers and Systems) Benchmarking Database.

State Table

13_1_4.3_1 Children who needed care right away for an illness, injury, or condition in the last 6 months who sometimes or never got care as soon as wanted, Medicaid, by State, 2010

State Data Source

AHRQ, CQuIPS, CAHPS.

State Denominator

Children under age 18 with Medicaid benefits who had an illness, injury, or condition that needed care right away in a clinic, emergency room, or doctor's office in the last 6 months.

State Numerator

Subset of the denominator with their parent or guardian's answer of "Sometimes" or "Never" to the question, "In the last 6 months, when you needed care right away for an illness, injury, or condition, how often did you get care as soon as you wanted?"

Comments

CAHPS surveys ask consumers and patients to report on and evaluate their experiences with health care. These surveys cover topics that are important to consumers and focus on aspects of quality that consumers are best qualified to assess, such as the communication skills of providers and ease of access to health care services.

Top of Page


 

Waiting Time

Measure Title

Emergency department (ED) visits in which patient had to wait an hour or more by urgency.

Measure Source

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

National Tables

13_2_1.1_1 Emergency department visits triaged as immediate or emergent at which patients waited to see a physician for 1 hour or more, per 10,000 population, United States, 2008-2009

13_2_1.1_2a-b Emergency department visits triaged as immediate or emergent at which patients waited to see a physician for 1 hour or more, per 10,000 population, United States, 2008-2009, by:

  1. Race.
  2. Ethnicity.

13_2_1.2_1 Emergency department visits triaged as urgent at which patients waited to see a physician for 1 hour or more, per 10,000 population, United States, 2008-2009

13_2_1.2_2a-b Emergency department visits triaged as urgent at which patients waited to see a physician for 1 hour or more, per 10,000 population, United States, 2008-2009, by:

  1. Race.
  2. Ethnicity.

National Data Source

CDC, NCHS, NHAMCS.

National Denominator

Visits to emergency departments in which the patient was triaged as immediate/emergent or urgent, where appropriate.

National Numerator

Subset of the denominator who waited to see a physician for 1 or more hours.

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Waiting Time

Measure Title

Hospital patients with heart attack who received percutaneous coronary intervention (PCI) within 90 minutes of arrival.

Measure Source

Centers for Medicare & Medicaid Services (CMS), Medicare Quality Improvement Organization Program (QIO).

National Table

13_2_3.1 Hospital patients with heart attack who received percutaneous coronary intervention within 90 minutes of arrival, United States, 2005-2009

National Data Source

CMS, QIO.

National Denominator

Discharged hospital patients with a principal diagnosis of acute myocardial infarction and documented receipt of percutaneous transluminal angioplasty (PCTA) or stent placement during the hospital stay, excluding people under age 18 and patients transferred from other acute care hospitals (including other emergency departments) and patients administered thrombolytic agents.

National Numerator

Subset of the denominator who received PCI (angioplasty or stent placement) within 90 minutes of arrival.

State Table

13_2_3.2 Hospital patients with heart attack who received percutaneous coronary intervention within 90 minutes of arrival, by State, United States, 2005-2009

State Data Source

CMS, QIO.

State Denominator

Same as national.

State Numerator

Same as national.

Comments

Time is measured in minutes from arrival to receipt of PCTA in patients with ST segment elevation or left bundle branch block on the electrocardiogram performed closest to hospital arrival time.

Effective October 2003, CMS revised this measure. Rates may not be comparable with earlier versions of the NHQR and NHDR.

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Waiting Time

Measure Title

Hospital patients with heart attack who received fibrinolytic medication within 30 minutes of arrival.

Measure Source

Centers for Medicare & Medicaid Services (CMS), Medicare Quality Improvement Organization Program (QIO).

National Tables

13_2_4.1 Hospital patients with heart attack who received fibrinolytic medication within 30 minutes of arrival, United States, 2005-2009

National Data Source

CMS, QIO.

National Denominator

Discharged hospital patients with a principal diagnosis of acute myocardial infarction and thrombolytic therapy documented during the hospital stay, excluding patients under age 18 and patients transferred from another acute care hospital (including another emergency department).

National Numerator

Subset of the denominator who received thrombolytic therapy within 30 minutes of arrival.

State Table

13_2_4.2 Hospital patients with heart attack who received fibrinolytic medication within 30 minutes of arrival, by State, United States, 2005-2009

State Data Source

CMS, QIO.

State Denominator

Same as national.

State Numerator

Same as national.

Comments

Time is measured in minutes from arrival to initiation of a thrombolytic agent in patients with ST segment elevation or left bundle branch block on the electrocardiogram performed closest to hospital arrival time.

Effective October 2003, CMS revised this measure. Rates may not be comparable with earlier versions of the report.

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Current as of March 2012
Internet Citation: Timeliness: 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/timeliness.html