2016 National Healthcare Quality and Disparities Report

Appendix A. Selected Measure Data

2016 National Healthcare Quality and Disparities Report

Trends in Access

Graph 1: Access

No change overall: 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 needed, 2002-2014

Line graph shows percentage of adult patients for the following years: 2002 - 15.3; 2003 - 14.3; 2004 - 14.2; 2005 - 15.1; 2006 - 15.3; 2007 - 13.9; 2008 - 15.4; 2009 - 14.7; 2010 - 14.4; 2011 - 13.6; 2012 - 14.7; 2013 - 14.6; 2014 - 12.4.

Source: Agency for Healthcare Research and Quality, Medical Expenditure Panel Survey, 2002-2014.
Note: For this measure, lower rates are better.

No change overall: People who were unable to get or delayed in getting needed prescription medicines in the last 12 months, 2002-2014

Line graph shows percentage of people for the following years: 2002 - 3.4; 2003 - 3.5; 2004 - 3.7; 2005 - 3.6; 2006 - 3.9; 2007 - 3.1; 2008 - 3.1; 2009 - 3.5; 2010 - 3.3; 2011 - 3.4; 2012 - 3.6; 2013 - 4; 2014 - 3.5.

Source: Agency for Healthcare Research and Quality, Medical Expenditure Panel Survey, 2002-2014.
Note: For this measure, lower rates are better.

No change overall: People with a usual primary care provider, 2002-2014

Line graph shows percentage of people for the following years: 2002 - 77.3; 2003 - 77.6; 2004 - 77.4; 2005 - 76.6; 2006 - 77.6; 2007 - 76.3; 2008 - 75.6; 2009 - 75.9; 2010 - 76.8; 2011 - 77.3; 2012 - 76.5; 2013 - 75.7; 2014 - 76.4.

Source: Agency for Healthcare Research and Quality, Medical Expenditure Panel Survey, 2002-2014.
Note: For this measure, lower rates are better.

Trends in Quality

Graph 2: Person-Centered Care

Improving overall: National composite measure: Adults who had a doctor's office or clinic visit in the last 12 months whose health providers sometimes or never listened carefully, explained things clearly, respected what they had to say, and spent enough time with them, 2002-2014

Line graph shows percentage of adults for the following years: 2002 - 11.1 percent; 2003 - 10.1 percent; 2004 - 9.9 percent; 2005 - 10 percent; 2006 - 10.1 percent; 2007 - 9.5 percent; 2008 - 9.8 percent; 2009 - 9.4 percent; 2010 - 8.1 percent; 2011 - 8.3 percent; 2012 - 7.9 percent; 2013 - 7.6 percent; 2014 - 6.4 percent.

Source: Agency for Healthcare Research and Quality, Medical Expenditure Panel Survey, 2002-2014.
Note: For this measure, lower rates are better.

Improving overall: Adult hospital patients who sometimes or never had good communication about medications they received in the hospital, 2009-2015

Line graph shows percentage of adult patients for the following years: 2009 - 12.72 percent; 2010 - 12.04 percent; 2011 - 11.5 percent; 2012 - 10.51 percent; 2013 - 10.13 percent; 2014 - 9.99 percent; 2015 - 9.93 percent.

Source: Centers for Medicare & Medicaid Services, Hospital Consumer Assessment of Healthcare Providers and Systems, 2009-2015.
Note: For this measure, lower rates are better. Good communication about medications means hospital staff explained clearly about effects and possible side effects of medications.

Graph 3: Patient Safety

Improving overall: Hospital admissions with central venous catheter-related bloodstream infection per 1,000 medical and surgical discharges of length 2 or more days, age 18 and over

Line graph shows percentage of hospital admissions for the following years: 2008 - 1.9 percent; 2009 - 1.67 percent; 2010 - 1.55 percent; 2011 - 1.18 percent; 2012 - 0.97 percent; 2013 - 0.77 percent; 2014 - 0.67 percent.

Source: Agency for Healthcare Research and Quality (AHRQ), Healthcare Cost and Utilization Project (HCUP), Nationwide Inpatient Sample (NIS), 2008-2011; State Inpatient Databases (SID), 2012-2014, weighted to provide national estimates using the same methodology as the 2008-2011 NIS; and AHRQ Quality Indicators (QIs), version 4.4. For more information on the sampling approach and included States, see the HCUP Methods Series Report on methods applying AHRQ QIs to HCUP data for the 2015 QDR (www.hcup-us.ahrq.gov/reports/methods/methods.jsp).
Note: For this measure, lower rates are better.

Improving overall: Adult patients receiving hip joint replacement due to fracture with adverse events, age 18 and over, overall

Line graph shows percentage of adult patients for the following years: 2009 - 16.4 percent; 2010 - 13.6 percent; 2011 - 15.01 percent; 2012 - 12.75 percent; 2013 - 8.65 percent; 2014 - 9.76 percent.

Source: Agency for Healthcare Research and Quality and Centers for Medicare & Medicaid Services, Medicare Patient Safety Monitoring System, 2009-2014.
Note: For this measure, lower rates are better.

Graph 4: Patient Safety

Improving overall: Hospital patients with an anticoagulant-related adverse drug event to low-molecular-weight heparin (LMWH) and factor Xa, age 18 and over, 2009-2014

Line graph shows percentage of patients for the following years: 2009 - 5.57 percent; 2010 - 4.8 percent; 2011 - 4.79 percent; 2012 - 4.57 percent; 2013 - 3.36 percent; 2014 - 3.52 percent.

Source: Agency for Healthcare Research and Quality and Centers for Medicare & Medicaid Services, Medicare Patient Safety Monitoring System, 2009-2014.
Note: For this measure, lower rates are better.

Graph 5: Healthy Living

Improving overall: Adolescents ages 16-17 years who received 1 or more doses of meningococcal conjugate vaccine, 2008-2014

Line graph shows percentage of adolescents for the following years: 2008 - 38.6 percent; 2009 - 51.8 percent; 2010 - 59.5 percent; 2011 - 69 percent; 2012 - 74.4 percent; 2013 - 77.3 percent; 2014 - 79.1 percent.

Source: Centers for Disease Control and Prevention, National Center for Immunizations and Respiratory Diseases and National Center for Health Statistics, National Immunization Survey—Teen, 2008-2014.

Graph 6: Healthy Living

Worsening overall: Women ages 21-65 who received a Pap smear in the last 3 years

Line graph shows percentage of women for the following years: 2000 - 87.5 percent; 2005 - 85.3 percent; 2008 - 84.5 percent; 2010 - 82.8 percent; 2013 - 80.7 percent.

Source: Centers for Disease Control and Prevention, National Center for Health Statistics, National Health Interview Survey, 2000-2013.
Note: Estimates are age adjusted to the 2000 U.S. standard population.

Worsening overall: Children ages 12-19 with obesity, 1999-2002 to 2011-2014

Line graph shows percentage of children for the following years: 1999-2002 - 16 percent; 2003-2006 - 17.6 percent; 2007-2010 - 18.2 percent; 2011-2012 - 20.5 percent; 2011-2014 - 20.5 percent.

Source: Centers for Disease Control and Prevention, National Center for Health Statistics, National Health and Nutrition Examination Survey, 1999-2002 to 2011-2014.
Note: For this measure, lower rates are better.

Other Priority Areas

Effective Treatment is addressed in Graphs 15 and 16, under Geographic Differences. Care Coordination and Care Affordability are addressed under Trends in Disparities and under Geographic Differences.

Trends in Disparities

Graph 7: Person-Centered Care

Improving overall: National: Adults who had a doctor's office or clinic visit in the last 12 months whose health providers sometimes or never showed respect for what they had to say, by insurance, 2014

Bar graph shows percentage by insurance type: Any Private - 10.7 percent; Uninsured - 4.2 percent.

Source: Agency for Healthcare Research and Quality, Medical Expenditure Panel Survey, 2014.
Note: For this measure, lower rates are better.

Large disparities: Hospice patients who received care consistent with their stated end-of-life wishes, by race, 2014

Bar graph shows percentage by race: White - 95.6 percent; Asian - 85.8 percent.

Source: National Hospice and Palliative Care Organization, Family Evaluation of Hospice Care Survey, 2014.

Graph 8: Patient Safety

Adults age 65 and over who received in the calendar year at least 1 of 33 potentially inappropriate prescription medications for older adults, by activity limitation, 2002-2014

Line graph shows percentage of adults age 65 and over. Text Description is below the image.

Year Basic Complex Neither Total
2002 28.9 33.1 14.1 19.3
2003 26.5 26.7 14 18.5
2004 23.3 26.8 13 16.7
2005 23.9 26.9 14.5 17.7
2006 22.6 25.8 11.7 15.9
2007 23.3 24.3 11.5 15.5
2008 19.3 20 11.6 13.9
2009 18 19.4 11.3 13.4
2010 21.2 21.8 10.4 13.9
2011 19.7 20.3 10.3 12.9
2012 18.1 19.2 10 12.5
2013 17.1 23.2 8.7 11.4
2014 17.2 21.7 8.2 11.7

Source: Agency for Healthcare Research and Quality, Medical Expenditure Panel Survey, 2002-2014.
Note: For this measure, lower rates are better.

Large disparities: Adults age 65 and over who received in the calendar year at least 1 of 33 potentially inappropriate prescription medications for older adults, by activity limitation, 2014

Bar graph shows percentage by activity limitation: Basic - 17.2 percent; Complex - 21.7 percent; Neither - 8.2 percent.

Source: Agency for Healthcare Research and Quality, Medical Expenditure Panel Survey, 2014.
Note: For this measure, lower rates are better.

Graph 9: Care Coordination

Large disparities: Emergency department visits for asthma, per 100,000 population (including inpatient admissions), ages 2-17, by income, 2014

Bar graph shows rate per 100,000 population by income: Poor - 1514.8; High Income - 548.7.

Source: Agency for Healthcare Research and Quality (AHRQ), Healthcare Cost and Utilization Project, Nationwide Emergency Department Sample, 2014.
Note: For this measure, lower rates are better.

Large disparities: Emergency department visits for asthma, per 100,000 population (including inpatient admissions), ages 18-39, by income, 2014

Bar graph shows rate per 100,000 population by income: Poor - 922.8; High Income - 309.6.

Source: Agency for Healthcare Research and Quality (AHRQ), Healthcare Cost and Utilization Project, Nationwide Emergency Department Sample, 2014.
Note: For this measure, lower rates are better.

Graph 10: Care Coordination

Emergency department visits for asthma, per 100,000 population (including inpatient admissions), ages 18-39, by income, 2008-2014

Line graph shows rate per 100,000 population by income. Text Description is below the image.

Year Poor High Income
2008 808.6 348.3
2009 881.3 343.3
2010 947.4 342.4
2011 839.5 341.2
2012 913 327.6
2013 969.6 338.8
2014 922.8 309.6

Source: Agency for Healthcare Research and Quality (AHRQ), Healthcare Cost and Utilization Project, Nationwide Emergency Department Sample, 2008-2014.
Note: For this measure, lower rates are better.

Emergency department visits for asthma, per 100,000 population (including inpatient admissions), ages 2-17, by income, 2008-2014

Line graph shows rate per 100,000 population by income. Text Description is below the image.

Year Poor High Income
2008 1195.6 553.1
2009 1411.8 604.7
2010 1339.9 524.6
2011 1254.5 621.2
2012 1500.3 587.5
2013 1500.3 587.5
2014 1514.8 548.7

Source: Agency for Healthcare Research and Quality (AHRQ), Healthcare Cost and Utilization Project,  Nationwide Emergency Department Sample, 2008-2014.
Note: For this measure, lower rates are better.

Graph 11: Care Coordination

Emergency department visits with a principal diagnosis related to mental health only, by income, 2007-2014

Line graph shows rate per 100,000 population by income. Text Description is below the image.

Year Poor High Income
2007 1369 763
2008 1489 806
2009 1598 764
2010 1613 849
2011 1537 884
2012 1703 859
2013 1715 873
2014 1993 941

Source: Agency for Healthcare Research and Quality (AHRQ), Healthcare Cost and Utilization Project, Nationwide Emergency Department Sample, 2007-2014.
Note: For this measure, lower rates are better.

Large disparities: Emergency department visits with a principal diagnosis related to mental health only, by income, 2014

Bar graph shows rate per 100,000 population by income: Poor - 1993; High Income - 941.

Source: Agency for Healthcare Research and Quality (AHRQ), Healthcare Cost and Utilization Project, Nationwide Emergency Department Sample, 2014.
Note: For this measure, lower rates are better.

Graph 12: Care Affordability

People unable to get or delayed in getting needed medical care who said it was due to financial or insurance reasons, by income, 2002-2014

Line graph shows percentage by income. Text Description is below the image.

Year Poor Low Income Middle Income High Income
2002 67.9 63.6 52.6 32.7
2003 71.5 64.8 52.1 35.4
2004 72.1 70.7 55.3 31
2005 72.6 70.2 56.7 30.8
2006 73.5 68.8 57.1 30.4
2007 72.3 63.5 53.3 32.2
2008 70.6 69.1 56.5 37.3
2009 69.4 70.6 62.6 39.3
2010 72.6 74.4 59.9 43.4
2011 66.7 71.1 61.5 32.5
2012 64.7 66.9 59.6 44.9
2013 70.3 62.7 55.7 43.8
2014 66.1 64.2 52.8 38.8

Source: Agency for Healthcare Research and Quality, Medical Expenditure Panel Survey, 2002-2014.
Note: For this measure, lower rates are better.

Large disparities: People unable to get or delayed in getting needed medical care who said it was due to financial or insurance reasons, by income, 2014

Bar graph shows percentage by income: Poor - 66.1; Low Income - 64.2; High Income - 38.8.

Source: Agency for Healthcare Research and Quality, Medical Expenditure Panel Survey, 2014.
Note: For this measure, lower rates are better.

Graph 13: Care Affordability

People unable to get or delayed in getting needed medical care who said it was due to financial or insurance reasons, by insurance, 2002-2014

Line graph shows percentage by insurance type. Text Description is below the image.

Year Uninsured Private Insurance
2002 85.5 42.7
2003 91 41.1
2004 87.2 42.4
2005 89.1 43.5
2006 89.9 42.1
2007 85.4 40.5
2008 88.1 44.9
2009 88 47.6
2010 88.6 51.2
2011 89.4 44.1
2012 91.2 49.8
2013 89.6 44.4
2014 88.1 52.1

Source: Agency for Healthcare Research and Quality, Medical Expenditure Panel Survey, 2002-2014.
Note: For this measure, lower rates are better.

Large disparities: People unable to get or delayed in getting needed medical care who said it was due to financial or insurance reasons, by insurance, 2014

Bar graph shows percentage by insurance type: Private Insurance - 52.1; Uninsured - 88.1.

Source: Agency for Healthcare Research and Quality, Center for Financing, Access, and Cost Trends, Medical Expenditure Panel Survey, 2014.
Note: For this measure, lower rates are better.

Geographic Differences

Graph 14: Care Coordination

Large disparities: Emergency department visits with a principal diagnosis related to mental health only, per 100,000 population, by residence location, 2014

Bar graph shows rate per 100,000 population by metro area: Large Fringe Metro - 1163; Large Central Metro - 1435.

Source: Agency for Healthcare Research and Quality (AHRQ), Healthcare Cost and Utilization Project, Nationwide Emergency Department Sample, 2014.
Note: For this measure, lower rates are better.

Graph 15: Care Coordination

Emergency department visits with a principal diagnosis related to substance abuse only per 100,000 population, by residence location, 2007-2014

Line graph shows rate per 100,000 population by metro area. Text Description is below the image.

Year Large Central Metro Large Fringe Metro Medium Metro Small Metro Micropolitan Noncore
2007 477 448 443 405 370 355
2008 514 422 491 449 378 368
2009 599 431 494 443 385 392
2010 627 455 525 454 398 392
2011 657 474 593 463 419 385
2012 660 510 586 450 422 358
2013 746 518 596 461 441 354
2014 758 572 698 559 517 415

Source: Agency for Healthcare Research and Quality (AHRQ), Healthcare Cost and Utilization Project, Nationwide Emergency Department Sample, 2007-2014.
Note: For this measure, lower rates are better.

Emergency department visits with a principal diagnosis related to substance abuse only per 100,000 population, by residence location, 2014

Bar graph shows rate per 100,000 population by metro area: Large Central Metro - 758; Large Fringe Metro - 572; Medium Metro - 698; Small Metro - 559; Micropolitan - 517; Noncore - 415.

Source: Agency for Healthcare Research and Quality (AHRQ), Healthcare Cost and Utilization Project, State Inpatient Databases, 2014; and AHRQ Quality Indicators, modified version 4.1.
Note: For this measure, lower rates are better.

Graph 16: Effective Treatment

Large disparities: Hospital admissions for congestive heart failure, per 100,000 population, by residence location, 2014

Bar graph shows rate per 100,000 population by metro area: Large Fringe Metro - 329; Micropolitan - 384.7; Noncore - 368.3.

Source: Agency for Healthcare Research and Quality (AHRQ), Healthcare Cost and Utilization Project (HCUP), National Inpatient Sample (NIS), 2014 and AHRQ Quality Indicators, version 4.4.

Graph 17: Effective Treatment

People age 12 and over who needed treatment for illicit drug use and who received such treatment at a specialty facility in the last 12 months, 2010-2015

Line graph shows percentage by metro area. Text Description is below the image.

Year Large Central Metro Large Fringe Metro Medium Metro Small Metro Micropolitan Noncore
2010 18.4 17.6 19 16.5 21.3  
2011 20.5 19 22 17.5 22.4 22.3
2012 15.2 19.8 21.3 27.4 17.9  
2013 21.7 17.2 16.5 13.8 21.7  
2014 19.5 22.4 20.6 16.8 23.3 19.3
2015 16.1 15.5 24.2 19 14.5 26.8

Source: Substance Abuse and Mental Health Services Administration, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2010-2015.
Note: Data unavailable for 2010, 2012, 2013 for noncore.

People age 12 and over who needed treatment for illicit drug use and who received such treatment at a specialty facility in the last 12 months, 2015

Bar graph shows percentage by metro area: Large Central Metro - 16.1 percent; Large Fringe Metro - 15.5 percent; Medium Metro - 24.2 percent; Small Metro - 19 percent; Micropolitan - 15.5 percent; Noncore - 26.8 percent.

Source: Substance Abuse and Mental Health Services Administration, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2015.

Graph 18: Care Affordability

National: People unable to get or delayed in getting needed prescription medicines who said it was due to financial or insurance reasons, 2014

Bar graph shows percentage by metro area: Large Fringe Metro - 69.8 percent; Small Metro - 41  percent.

Source: Agency for Healthcare Research and Quality, Medical Expenditure Panel Survey, 2014.

Page last reviewed July 2017
Page originally created June 2017
Internet Citation: Appendix A. Selected Measure Data. Content last reviewed July 2017. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/research/findings/nhqrdr/nhqdr16/appendixa-graphs.html