NHQR and NHDR Appendix Tables With Information on Child and Adolescent

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.

List of Measures: NHQR and NHDR Appendix Tables With Information on Child and Adolescent Health Care Quality and Accessi

The 2004 National Healthcare Quality Report (NHQR) examines 179 measures within four quality components of the Nation's health care system: effectiveness, patient safety, timeliness, and patient centeredness; within the effectiveness component, nine condition areas or care settings are tracked—cancer, diabetes, end stage renal disease, heart disease, HIV/AIDS, maternal and child health, mental health, respiratory diseases, and nursing home/home health care. Where data are available, the NHQR also presents State-level findings.

The 2004 National Healthcare Disparities Report (NHDR) uses the same quality components as its companion report to examine disparities in health care quality overall. In addition, the NHDR examines disparities in quality and access to care for AHRQ's congressionally designated priority populations, including ethnic and racial minorities, low income groups, rural residents, elderly, women, children, and people with special health care needs.

The table below lists the measures in the NHQR and NHDR with data for children and adolescents under age 18. Table numbers refer to the detailed appendix tables in each report with data on that population. These appendix tables are online at: www.qualitytools.ahrq.gov/

TopicMeasureNHQR National Table NumberNHQR State Table NumberNHDR National Table Numberii

Quality of Careiii: Effectivenessiv

Cancer

Cancer deaths per 100,000 persons per year for all cancers (ages 0-17)v1.8a1.8b5a,b

Quality of Careiii: Effectivenessiv

End Stage Renal Disease

Percent of dialysis patients registered on waiting list for transplantation (ages 0-17)1.27ax22a,b
Percent of patients with treated chronic kidney failure who receive a transplant within 3 years of renal failure (ages 0-17)1.28ax23a,b

Quality of Careiii: Effectivenessiv

Heart Disease

Deaths per 1,000 pediatric heart surgery admissions (ages 0-4, 5-9, 10-14, 15-17)1.48x33a

Quality of Careiii: Effectivenessiv

HIV and AIDS

New AIDS cases per 100,000 population (ages 13-17)1.54x34a
HIV infection deaths per 100,000 population (ages 0-17)1.55ax35a,b

Quality of Careiii: Effectivenessiv

Maternal and Child Health: Maternity Care

Pregnant women receiving prenatal care in first trimester (ages < 15, 15-19)xx36a,b
Maternal deaths per 100,000 live births (age < 20)1.59a1.59b43a,b
Infant mortality per 1,000 live births, all (maternal ages < 15, 15-19)1.58ax39a,b
Infant mortality per 1,000 live births, birthweight < 1,500 grams (maternal ages < 15, 15-19)xx40a,b
Infant mortality per 1,000 live births, birthweight 1500-2499 grams (maternal ages < 15, 15-19)xx41a,b
Infant mortality per 1,000 live births, birthweight > 2,499 grams (maternal ages < 15, 15-19)xx42a,b
Percent of live-born infants with low and very low birthweight (less than 2,500 grams, less than 1,500 grams) (maternal ages < 15, 15-19)1.57a
(<2,500 g)
1.57b
(<1,500 g)
1.57c (<2,500 g)
1.57d (<1,500 g)
37a,b
38a,b

Quality of Careiii: Effectivenessiv

Maternal and Child Health: Immunizations, children ages 19-35 months

Percent of children 19-35 months who received all recommended vaccines1.60a1.60b44a,b,c
Percent of children 19-35 months who received 4 doses of diphtheria-pertussis-tetanus vaccinexx45a,b,c
Percent of children 19-35 months who received 3 doses of polio vaccinexx46a,b,c
Percent of children 19-35 months who received 1 dose of measles-mumps-rubella vaccinexx47a,b,c
Percent of children 19-35 months who received 3 doses of Haemophilus influenzae type B vaccinexx48a,b,c
Percent of children 19-35 months who received 3 doses of hepatitis B vaccinexx49a,b,c
Percent of children 19-35 months who received 1 dose of varicella vaccinexx50a,b,c

Quality of Careiii: Effectivenessiv

Maternal and Child Health: Immunizations, adolescents ages 13-15

Percent of adolescents (ages 13-15) reported to have received 3 or more doses of hepatitis B vaccine1.61x51a,b,c
Percent of adolescents (ages 13-15) reported to have received 2 or more doses of measles-mumps-rubella vaccine1.62x52a,b,c
Percent of adolescents (ages 13-15) reported to have received 1 or more doses of tetanus-diphtheria booster1.63x53a,b,c
Percent of adolescents (ages 13-15) reported to have received 1 or more doses of varicella vaccine1.64x54a,b,c

Quality of Careiii: Effectivenessiv

Maternal and Child Health: Overweight prevention

Percent of children under age 18 who had their height and weight measured by a doctor or other health provider1.67x56a,b,c
Percent of children ages 2-17 for whom a doctor or other health care provider gave advice about amount and kind of physical activity1.68x57a,b,c
Percent of children ages 2-17 for whom a doctor or other health care provider gave advice about eating healthy1.69x58a,b,c

Quality of Careiii: Effectivenessiv

Maternal and Child Health: Vision health

Percent of children ages 3-6 whose vision was checked by a doctor or other health provider1.70X59a,b,c

Quality of Careiii: Effectivenessiv

Maternal and Child Health: Passive smoking

Percent of children under age 18 for whom a doctor or other health provider gave advice about how smoking in the house can be harmful1.71x60a,b,c

Quality of Careiii: Effectivenessiv

Maternal and Child Health: Injury prevention

Percent of children under age 18 for whom a doctor or other health provider gave advice about using car safety restraints1.72x(see 61-64 below)
Children 0-40 lbs with advice to parent or guardian about using child car safety seats (ages 0-5, 6-17)xx61a,b,c
Children 40-80 lbs with advice to parent or guardian about using booster seats (ages 0-5, 6-17)xx62a,b,c
Children over 80 lbs with advice to parent or guardian about using lap and shoulder belts (ages 0-5, 6-17)xx63a,b,c
Percent of children ages 2-17 for whom a doctor or other health provider gave advice about using a helmet when riding a bicycle or motorcycle1.73x64a,b,c

Quality of Careiii: Effectivenessiv

Maternal and Child Health: Dental health

Percent of children ages 2-17 who report dental visit in last year1.65x65a,b,c

Quality of Careiii: Effectivenessiv

Maternal and Child Health: Management of gastroenteritisvi

Hospital admissions for pediatric gastroenteritis per 100,000 population less than 18 years of age1.66a1.66b55a

Quality of Careiii: Effectivenessiv

Mental Health

Deaths due to suicide per 100,000 population (ages 0-17)1.77a1.77b66a,b

Quality of Careiii: Effectivenessiv

Respiratory Diseases

Antibiotic prescribed at visit with diagnosis of common cold by selected characteristics, United States, per 10,000 visits (ages 0-17)1.91x75a
Hospital admissions for pediatric asthma (under age 18)1.93a1.93b76a
Hospital admissions for bacterial pneumonia per 100,000 population In Indian Health Service hospitals (ages 0-17)xx220a
Tuberculosis patients who compete a curative course of treatment within 12 months of initiation of treatment (ages 0-17)xx78a,b,c,d

Quality of Care: Patient Safety

Birth-related trauma, neonates and mothers

Birth trauma to neonate, per 1,000 live births2.1x114a
Obstetric trauma—cesarean delivery (ages 10-14, 15-17)2.22xx
Obstetric trauma—per 1,000 instrument-assisted deliveries (ages 10-14, 15-17)xx115a
Obstetric trauma—per 1,000 vaginal deliveries without instrument assistance (ages 10-14, 15-17)xx116a

Quality of Care: Patient Safety

Potentially avoidable deaths

Deaths per 1,000 admissions in low mortality DRGs (ages 0-17), some exclusions2.2x118a
Failure to rescue or deaths per 1,000 discharges having developed specified complications of care during hospitalization (excluding patients transferred in or out, patients admitted from long-term care facilities, neonates, and patients over 74 years old), (ages 0-17)2.3x119a

Quality of Care: Patient Safety

Transfusion reactions

Transfusion reactions per 1,000 discharges (excluding neonates) (ages 0-17)2.4axx
Transfusion reactions per 100,000 population (excluding neonates) (ages 0-17)2.4bxx

Quality of Care: Patient Safety

Nosocomial infections

Selected infections due to medical care per 1,000 discharges (ages 0-17)2.11ax101a
Selected infections due to medical care per 100,000 population (ages 0-17)2.11bxx
Ventilator-associated pneumonia in infants weighing ‹1,000 grams at birth in intensive care, per 1,000 days of use2.25xx
Central line-associated bloodstream infection in infants weighing 1,000 grams or less at birth in intensive care, per 1,000 days of use2.7xx
Postoperative sepsis per 1,000 elective-surgery discharges of longer than 3 days (excluding obstetric conditions, others) (ages 0-17)2.17xx

Quality of Care: Patient Safety

Complications of care

Foreign body left in body during procedure per 1,000 discharges (excluding neonates) (ages 0-17)2.5ax113a
Foreign body left in body during procedure per 100,000 population (excluding neonates) (ages 0-17)2.5bxx
Complications of anesthesia per 1,000 surgical discharges (ages 0-17)2.8xx
Decubitus ulcers per 1,000 discharges of length 5 or more days (excluding obstetrical patients and others) (ages 0-17)2.9x108a

Quality of Care: Patient Safety

Injuries or adverse events due to technical errors

Iatrogenic pneumothorax per 1,000 discharges (excluding neonates and obstetric admissions, others) (ages 0-17)2.10ax111a
Iatrogenic pneumothorax per 100,000 population (excluding neonates and obstetric admissions, others) (0-17)2.10bxx
Accidental puncture or laceration during procedures per 1,000 discharges (excluding obstetric admissions) (ages 0-17)2.18ax110a
Accidental puncture or laceration during procedures per 100,000 population (excluding obstetric admissions) (ages 0-17)2.18bxx
Postoperative hemorrhage or hematoma per 1,000 surgical discharges (excluding obstetric admissions) (ages 0-17)2.13x103a
Postoperative physiologic and metabolic derangements per 1,000 elective surgical discharges (excluding obstetric admissions, others) (ages 0-17)2.14x106a
Postoperative respiratory failure per 1,000 elective surgical discharges (excluding obstetric conditions, others) (ages 0-17)2.15x105a
Postoperative pulmonary embolism or deep vein thrombosis per 1,000 surgical discharges (excluding obstetrics, others) (ages 0-17)2.16x104a
Postoperative abdominal wound dehiscence per 1,000 abdominopelvic surgery discharges (excluding obstetric conditions) (ages 0-17)2.19ax112a
Postoperative abdominal wound dehiscence per 100,000 population (excluding obstetrics) (ages 0-17)2.19bxx

Quality of Care: Timeliness

Getting an appointment as soon as wanted

Among children under age 18 who had appointments reported for routine health care in the last 12 months, percent distribution of how often they got an appointment as soon as wanted3.4a3.4b, 3.4c225A a,b,c
225B a,b,c
225C a,b,c
Among children under age 18 who had appointments reported for an illness or injury in the last 12 months, percent distribution of how often they got an appointment as soon as wanted3.6a3.6b, 3.6c226A a,b,c
226B a,b,c
226C a,b,c

Quality of Care: Timeliness

Emergency department (ED) waits

ED visits: Percent ED visits where patient was admitted to the hospital or transferred to other facility whose ED visit was greater than or equal to six hours (ages 0-17)3.7xx
ED visits: Percent of patients who left without being seen3.8xx
Quality of Care: Patient CenterednessAmong children under age 18 who had a doctor's office or clinic visit in the last 12 months, percent distribution of how often their health providers spent enough time with them and their parents4.8ax231A a,b,c
231B a,b,c
231C a,b,c
Among children under age 18 who had a doctor's office or clinic visit in the last 12 months, percent distribution of how often their health providers explained things in a way that parents could understandxx229A a,b,c
229B a,b,c
229C a,b,c
Among children under age 18 who had a doctor's office or clinic visit in the last 12 months, percent distribution of how often their health providers showed respect for what parents had to sayxx230A a,b,c
230B a,b,c
230C a,b,c
Among children under age 18 who had a doctor's office or clinic visit reported in the last 12 months, percent distribution of how often their health care providers listened carefully to their parents4.2aviix228A a,b,c
228B a,b,c
228C a,b,c
Children with special health care needs without family-centered care (ages 0-5, 6-11, 12-17)xx237a,b,c
Quality of Care: Overall MeasuresAmong children under age 18 who had a doctor's office or clinic visit in the last 12 months, distribution of parents ratings for health care received5.2a5.2b232A,B,C

Access to Careviii: Getting into the Health Care System

Health insurance coverage

People under age 65 with health insurance (ages 0-17)xx120a,b,c
People under age 65 with public health insurance only (ages 0-17)xx121a,b,c
People under age 65 with any private health insurance (ages 0-17)xx122a,b,c
People uninsured all year (ages 0-17)xx124a,b,c
Children with special health care needs without health insurance at some point in past year) (ages 0-5, 6-11, 12-17)xx238a,b,c
Children with special health care needs with insurance that is not adequate (ages 0-5, 6-11, 12-17)xx239a,b,c

Access to Careviii: Getting into the Health Care System

Usual source of care

People who have a specific source of ongoing care (ages 0-17)3.1ax127a,b,c
People in fair or poor health who have a specific source of ongoing care (ages 0-17)xx128a,b,c
People with a hospital, emergency room, or clinic as source of ongoing care (ages 0-17)xx129a,b,c
People without a usual source of care who indicate a financial or insurance reason for not having a source of care (ages 0-17)xx131a,b,c
People who have a usual primary care provider (ages 0-17)xx132a,b,c
People in community health centers who have a usual source of care (ages 0-17)xx223a,b,c
Children with special health care needs with no usual source of care (ages 0-5, 6-11, 12-17)xx240a,b,c
Access to Careviii: Getting Care Within the Health Care SystemPeople with provider who has office hours nights or weekends (ages 0-17)xx141a,b,c
People with difficulty getting appointments on short notice (ages 0-17)xx142a,b,c
People with difficulty contacting provider over the telephone (ages 0-17)xx143a,b,c
People not very satisfied with professional staff at provider's office (ages 0-17)xx145a,b,c
People who usually wait › 30 minutes before seeing provider (ages 0-17)xx146a,b,c
Emergency/urgent emergency department visits with wait ›= 1 hour (ages 0-17)xx147a
Semi-urgent/non-urgent emergency department visits with wait > = 1 hour (ages 0-17)xx148a
Emergency department visits in which the patient left without being seen (ages 0-17)xx149a
Children with special health care needs with unmet need for specific health care services (ages 0-5, 6-11, 12-17)xx241a,b,c
Children with special health care needs needing specialty care who had difficulty getting referral in past year (ages 0-5, 6-11, 12-17)xx242a,b,c
Access to Careviii: Patient Perceptions of CarePeople with provider who usually asks about medications and treatments other doctors may give (ages 0-17)xx150a,b,c
People not satisfied with quality of care received from providerxx155a,b,c

Access to Careviii: Health Care Utilizationix

General medical care

People with an office or outpatient visit in the past year (ages 0-17)xx171a,b,c
People with a prescription medication in the past year (ages 0-17)xx172a,b,c
People with a dental visit in the past year (ages 0-17)xx173a,b,c
People with an emergency room visit in the past year (ages 0-17)xx174a,b,c
People with an inpatient discharge in the past year (ages 0-17)xx175a,b,c
Outpatient visits per 100 population (ages 0-17)xx176a
Emergency department visits per 100 population (ages 0-17)xx177a
Total hospitalizations per 100 population (ages 0-17)xx178a

Access to Careviii: Health Care Utilizationix

Avoidable admissions

Bacterial pneumonia hospital admissions per 100,000 population (excluding sickle cell or hemoglobin-S condition, transfers from other institutions, and obstetric and neonatal admissions), by race (ages 0-17)xx190a
Hospital admissions with perforated appendices per 1,000 admissions with appendicitis (ages 0-17)xx191a

Access to Careviii: Health Care Utilizationix

Mental health care and substance abuse treatment

People age 12 and older who received illicit drug or alcohol abuse treatment in the past year (ages 12-17)xx197a,b
People age 12 and older who needed treatment at a specialty facility for illicit drug use and who received such treatment in the past year (ages 12-17)xx198a,b
Inpatient admissions to specialty mental health organizations per 100,000 population (age ‹ 18)xx199a,b
Residential care admissions to specialty mental health organizations per 100,000 population (age ‹ 18)xx200a,b
‹ 24 hour care admissions to specialty mental health organizations per 100,000 population (age ‹ 18)xx201a,b

Access to Careviii: Health Care Utilizationix

Ambulatory care

Outpatient visits where patient was seen before in clinic or practice (ages 0-17)xx207a
Outpatient visits where patient was seen by patient's primary care provider (ages 0-1xx208a
Outpatient visits where patient was seen for non-illness care (ages 0-17)xx209a
Outpatient visits with counseling or education about diet and nutrition (ages 0-17)xx210a
Outpatient visits with counseling or education about exercise (ages 0-17)xx211a
Outpatient visits with counseling or education about tobacco use and exposure (ages 0-17)xx212a
Outpatient visits where physician spent more than 30 minutes with patient (ages 0-17)xx213a
Outpatient visits where patient was referred by another physician or health plan (ages 0-17)xx214a
Outpatient visits where patient was referred to another physician (ages 0-17)xx215a
Emergency department visits related to injuries per 10,000 population (ages 0-17)xx216a
Emergency department visits for asthma per 10,000 population (ages 0-17)xx217a
Emergency department visits where patient was seen by intern/resident only (ages 0-17xx218a

Key: x = no data or no child data reported.

iNHQR and NHDR tables and full text of the reports are available at: http://www.ahrq.gov/qual/measurix.htm
iiThe NHDR contains information on children by race, ethnicity, and/or income, as available.
iiiIn each report, quality measures are grouped in 4 major domains of quality: Effectiveness, Safety, Timeliness, and Patient Centeredness.
ivEffectiveness of care measures in each report are organized primarily by disease (cancer, diabetes, end stage renal disease, heart disease, HIV and AIDS, mental health, respiratory diseases). In addition there are sections for maternal and child health, and nursing home and home health care.
vThe age group(s) in parentheses is the child/adolescent age group for which there are data in the respective table.
viFor reports on other preventable hospitalizations, refer to NHDR table 220 (Admissions for bacterial pneumonia per 100,000 in Indian Health Service hospitals), NHQR tables 1.93a and 1.93b (hospital admissions for pediatric asthma) and NHDR table 76 (hospital admissions for asthma per 100,000 population under age 18).
viiBy whether child had a special health care need.
viiiIn addition to the inclusion of quality measures, the NHDR also includes data on access to care.
ixIn addition to the inclusion of quality measures, the NHDR also includes data on health care utilization.

Current as of October 2012
Internet Citation: NHQR and NHDR Appendix Tables With Information on Child and Adolescent. October 2012. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/research/findings/nhqrdr/nhqrdrchapp.html